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Click ‘Get Form’ to open it in the editor.
Begin by entering your personal information in the Claimant section, including your name and Social Security Number (SSN).
For each week you are claiming, fill out the 'Week #' field and record the date of contact. Ensure you note the beginning and ending dates for that week.
In the 'Company Contacted' section, list the name of the employer you reached out to.
Select your contact method from options such as In person (I), Telephone (T), Email (E), Online (O), or Fax (F).
Depending on your contact method, provide relevant details like physical address, telephone number, email address, website address, or fax number.
Indicate the position you are seeking and summarize the results of your contact in the designated field.
If applicable, attach any confirmation emails or numbers for online contacts directly within our platform.
Finally, affirm that all information is accurate by signing and dating at the bottom of the form.
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FORM 17 - North Carolina Industrial Commission - NC.gov
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