Form Eb 12 PDF Details

For those navigating the complexities of unemployment benefits, the EB-12 form serves as a vital tool in ensuring the continuity and accuracy of the assistance received. Distributed by the Department of Workforce Development's Unemployment Insurance Division, this weekly work search log is designed to streamline the process of recording and submitting proof of job search activities—a requirement for those seeking extended benefits. Located in Madison, Wisconsin, but accessible online for convenience, the form simplifies the submission process by allowing claimants to file their weekly claims digitally, thereby expediting the processing time. However, for individuals without internet access, the physical form is still an option, requiring detailed entries of job search efforts including dates, types of work sought, methods of contact, and outcomes. Crucially, any missing information can delay or even jeopardize the receipt of payments, making thorough completion essential. Despite its significance in aiding job seekers during challenging times, claimants are explicitly instructed not to request employer signatures on this document, further emphasizing the form's role as a self-reported tool to be verified by the Unemployment Insurance Division.

QuestionAnswer
Form NameForm Eb 12
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesClaimant, completing, Workforce, WI

Form Preview Example

Department of Workforce Development

Weekly Work Search Log

Unemployment Insurance Division

EB-12

PO Box 7905

Madison, Wl 53707

Fax: 608-327-6499

For faster processing of your weekly claim and extended benefits work search log, file your next WEEKLY

claim online at http://unemployment.wisconsin.gov. After completing the regular weekly claim

questions, you will be presented the online work search log.

If you do not have access to the Internet, use this form to record your work search contacts.

Be sure to include all of the requested information, as shown below. Payment may be delayed while we review your work search log.

If you do not fill in every blank, benefit payment will be delayed and possibly denied.

Do not ask any employer to sign this form.

Full Name (please print)

Social Security Number

Report for the week of (Sunday)through (Saturday)

Contact No. 1

Date

Type of Work

Method of Contact (in person, internet, telephone, mail, etc.)

Employer Name

Address (or email or web address)

City

State

Zip Code

Phone (or Fax) Number (if known), including area code

Person Contacted (if known)

Result of Contact

Contact No. 2

Date

Type of Work

Method of Contact (in person, internet, telephone, mail, etc.)

Employer Name

Address (or email or web address)

City

State

Zip Code

Phone (or Fax) Number (if known), including area code

Person Contacted (if known)

Result of Contact

Claimant Signature

Date Signed

EB-12 (R. 12/2010)

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step 1 to filling in search

In the Method of Contact in person, Employer Name, Address or email or web address, City, State, Zip Code, Phone or Fax Number if known, Person Contacted if known, Result of Contact, Contact No, Date, Type of Work, Method of Contact in person, Employer Name, and Address or email or web address area, type in your data.

search Method of Contact in person, Employer Name, Address or email or web address, City, State, Zip Code, Phone or Fax Number if known, Person Contacted if known, Result of Contact, Contact No, Date, Type of Work, Method of Contact in person, Employer Name, and Address or email or web address blanks to fill out

The system will ask you to give specific necessary particulars to effortlessly complete the segment Phone or Fax Number if known, City, State, Zip Code, Person Contacted if known, Result of Contact, Claimant Signature, EB R, and Date Signed.

Completing search step 3

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