Deo Form Ucb 231 Euc PDF Details

Understanding the DEO UCB 231 EUC form is essential for those navigating the intricacies of emergency unemployment compensation. Created by the Department of Economic Opportunity, this form serves as a Claimant Eligibility Review Questionnaire to comply with the Middle Class Tax Relief and Job Creation Act of 2012. Its primary purpose is to ensure that individuals continue to meet the criteria necessary for receiving emergency unemployment benefits. Completing this form involves providing detailed personal information, such as contact details and social security number, alongside specific employment-related data like the types of work sought, availability, and willingness to commute. Additionally, claimants must disclose any pension receipts or job offers, ensuring honesty to avoid penalties under Florida Unemployment Compensation Law. Significantly, it underscores the mandatory reporting of gross earnings to appropriately claim benefits, reflecting the tightrope walk between legal obligation and the need for support during unemployment. With privacy considerations duly noted, the form's completion is a crucial step in maintaining benefit eligibility, marked by clear stipulations on the provision and use of personal data for both reporting to the IRS and eligibility verification for other programs.

Form NameDeo Form Ucb 231 Euc
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other namesEUC, Tues, 1986, 2012

Form Preview Example


Unemployment Compensation

Claimant Eligibility Review Questionnaire

The eligibility review is being conducted to comply with the requirements of the Middle Class Tax Relief and Job Creation Act of 2012, P.L. 112-96, and to ensure your continued eligibility for emergency unemployment compensation (EUC) benefits. Please answer all questions on this form and bring the completed form when you report for reemployment services.

Failure to do so will result in delay or denial of benefits.

(Print) NAME:







1. List the types of work you are seeking and the number of years of experience you have in each type of work:



























Lowest wage you are willing to accept: $





per (Circle one): Hour






What days and hours are you willing to work? (Circle the days):



Tues Wed Thurs Fri Sat




List the hours that you will work during the days you indicated above:















































How many miles ONE WAY are you willing to commute to work?


















How will you get to work? (car, bus, walk, etc)



















































Is there any reason you cannot accept an offer of full-time work? Yes














If “Yes”, what is the reason?




























Have you started receiving a pension from a prior employer since you filed your claim? Yes







Do you have any definite offer of work? Yes






















If “Yes”, enter your scheduled start date:




























Employer’s name:







Employer’s Address: (Number and Street)








































































The information that I have furnished above is true and correct to the best of my knowledge. If I am successful in finding work, when claiming benefits I will correctly report my gross earnings (before taxes) during the week in which they are earned. If I have any questions regarding the unemployment compensation process, I will contact the Customer Service Center of the Department of Economic Opportunity at 1-800-204-2418. I understand that the Florida Unemployment Compensation Law imposes penalties for making false statements to obtain unemployment benefits.

Claimant’s Signature:




Information you provide to this Department is voluntary and confidential but is required to process your claim. Pursuant to the Internal Revenue Code of 1986, the Social Security Act, 42 U.S.C. 1320b-7(a)1, and s. 443.091(1)(h), F.S., disclosure of your Social Security number is mandatory. Social Security numbers will be used by the Department to report the benefits you receive to the Internal Revenue Service as potential taxable income. In accordance with the Federal Deficit Reduction Act, an amendment to the Federal Social Security Act, and 5 U.S.C. 552a(o)(1)(D), information you provide is subject to verification through computer matching programs and information about your wages and claim may be provided to other federal, state and local agencies or their contractors for verification of eligibility under other government programs to ensure benefits have been properly paid and for statistical and research purposes.

An equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities.

DEO FORM UCB-231 EUC (3/12)