New York State Department of Labor Unemployment Insurance Division - labor ny 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Social Security Number and Claimant Name at the top of the form. If your name has changed, include your previous name as well.
3. In Part A, answer the questions regarding your waiting week. For each question, select 'Yes' or 'No' and provide additional details where required, such as hours worked and reasons for any refusals.
4. Complete the Claimant Certification section by affirming that all statements are true. Sign and date the form, ensuring to update your address if it has changed.
5. Once you have filled out Part A, return the form to your employer for them to complete Part B. They will need to certify their portion before submission.

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