EXTREMELY IMPORTANT NOTE REGARDING THE ENTRY OF
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Before submitting this form please verify that all required information is
fully completed and that all information matches what you would have
provided to the Department of Labor when you originally filed your claim.
* - Denotes
that I am the claimant indicated below. I understand that the law
provides penalties for making false statements or any
misrepresentation to obtain unemployment benefits.
* Full Name:
* Mother's Maiden Name (for
* Date of Birth (for
Email Address: (to contact you
only for confirmation)
I worked in the US Virgin Islands and I am trying to file a USVI
I am currently residing in Connecticut