Benefit Appeals Report -- Extended Benefits (ETA 5130)

Benefit Appeals Report

OMB: 1205-0172

IC ID: 239600

Documents and Forms

Document Name Document Type
Form ETA 5130 Benefit Appeals Report -- Extended Benefits (ETA 5130) Form and Instruction
ETA 5130 Benefit Appeals Report DOL-ETA 1205-0172 - ETA 5130 - 07.12.23 OCIO2.docx Form and Instruction