Form ADJ034F at a glance
What it is: State of Illinois Department of Employment Security Work Search Record.
A filled-in Form ADJ034F example: a claimant lists three work search contacts for one week

How to fill out Form ADJ034F, box by box
More rules for Form ADJ034F
Use this form to keep a record of the work search efforts you made.
Be sure that all requested information is provided. Failure to do so may result in a denial of benefits.
If you need additional pages, contact your local office or duplicate this form.
Do not discard your written work search record for any week being claimed until 53 weeks have passed from the end of that week.
If there is an appeal pending regarding your active work search for a week, keep your written work search record until there has been a final resolution of the matter.
A determination that you were actively seeking work during a week being claimed is subject to reconsideration despite the fact that you have been paid benefits or returned to work.
Sources
[1] Form ADJ034F (09/2011), Work Search Record, Illinois Department of Employment Security (the Official source link on this page).


