Blank work history template 2026

1. Click ‘Get Form’ to open the blank work history template in the editor.
2. Begin by entering your Claimant Information at the top of the form. Fill in your Last Name, First Name, Middle Initial (MI), and ID or SSN as required.
3. For each employer listed (up to four), provide detailed information. Start with Employer Name, followed by Address 1 and Address 2 if applicable. Include City, State, and Zip Code.
4. Next, indicate your Start Date and Last Day Worked for each position. Be sure to enter the Number of Actual Days Worked and specify the State Where Work Was Performed.
5. Select the reason for leaving from the options provided: Discharge, Voluntary Leave, Labor Dispute, or Retirement. Repeat this process for all employers listed on the form.
6. If you need more space for additional employers or details, feel free to use extra sheets as necessary.
7. Once completed, review your entries for accuracy before submitting it back to your Illinois Department of Employment Security Reporting Office as instructed.

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