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MyFlorida - AWI Benefit Payment Control
 

Benefit Payment Control

Notification of Fraud

 
THIS FORM IS TO REPORT UNEMPLOYMENT COMPENSATION FRAUD ONLY. 
IF YOU WANT TO FILE AN UNEMPLOYMENT COMPENSATION CLAIM 
PLEASE VISIT THE UNEMPLOYMENT COMPENSATION CLAIM  WEBSITE.
 
Please provide the following information, if known.

   
Claimant's Last Four Digits of Social Security Number:
 
Claimant's Name:
 
Name of business where claimant is working:
 
Phone number and contact person where claimant is working:
 
Job Site Address:
 
Dates Worked:
 
Type of Work Performed:
 
Additional Information: