Statement Regarding Benefit Claim for Days Worked

RUIA Investigations and Continuing Entitlement

OMB: 3220-0025

IC ID: 179869

Documents and Forms

Document Name Document Type
Form UI-48 (08-17) Statement Regarding Benefit Claim for Days Worked Form and Instruction
UI-48 (08-17) Statement Regarding Benefits Claimed for Days Worked Form UI-48 (08-17).pdf Form and Instruction