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Forms
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Alternate Contact
Unemployment Compensation |
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 | Occasionally, we must contact separating employers to obtain additional information regarding the claimant. If you would like to receive these requests for additional information via fax or e-mail, please complete this form and return it with the Notice of Claim and Request for Separation Information. | ||
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Application for Surface Mining Permit and Plan of Reclamation
Mining and Reclamation |
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DIR Agreement for Direct Deposit Form DD-1
Unemployment Compensation |
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| Direct Deposit form DD-1. Also see Direct Deposit Fact Sheet, form DD-2 | ||
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DIR Direct Deposit Fact Sheet - form DD-2
Unemployment Compensation |
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| Direct deposit is the electronic transfer of your unemployment benefits directly into your checking or savings account. It is the most convenient and dependable way to receive your benefits. No more wondering if your check was lost or stolen. No more check cashing fees. There is no fee for direct deposit. | ||
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Employer Affidavit for Filing Electronic Partials
Unemployment Compensation |
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Fraud Report Information Sheet
Internal Security |
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Information Disclosure Pre-employment Release, Form 480-A (Revised 6-22-06)
DIR General |
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Information Disclosure Request by an Individual, Form 480 (Revised 1/2006)
Unemployment Compensation |
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| This form allows you to request information from your own file. | ||
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Internal Security Fraud Report
Internal Security |
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Internal Security Report for Fraud and/or Abuse Incidents (Form ISEC-F)
Internal Security |
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Internal Security Report for Non-Fraudulent Incidents (Form ISEC-1)
Internal Security |
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Law Enforcement Request
Internal Security |
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MR Comprehensive Reclamation Plan
Mining and Reclamation |
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Partials Employee Consent Form
Unemployment Compensation |
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Petition for Trade Adjustment Assistance
Unemployment Compensation |
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| This is a petition for Trade Adjustment Assistance under Section 221(a) of the Trade Adjustment Assistance Act of 2009, as amended. See the Instructions and Information section on Page 1 for details on annotated items. | ||
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Petition For Trade Adjustment Assistance - Spanish Version
Unemployment Compensation |
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| This is the Spanish version of a petition for Trade Adjustment Assistance under Section 221(a) of the Trade Adjustment Act of 2009, as amended. See the Instructions and Information section on Page 1 for details on annotated items. | ||
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UC Application for Voluntary Election (Form UC-6)
Unemployment Compensation |
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UC Application to Determine Liability (UC Form SR-2)
Unemployment Compensation |
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UC Application to Determine Liability Instructions
Unemployment Compensation |
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UC Application to Determine Liability Pertinent Coverage Provisions
Unemployment Compensation |
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UC Power of Attorney
Unemployment Compensation |
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UC Report of Employer Account Changes
Unemployment Compensation |
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UC Statement of Correct Information Previously Reported (Form UC-10-C)
Unemployment Compensation |
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WC Alabama First Report of Injury Codes
Workers' Compensation |
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WC Application for Certification for Bill Screening (Form WC 50)
Workers' Compensation |
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WC Application for Self Insurance (Form WC 18)
Workers' Compensation |
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WC Assessment Form (Instructions)
Workers' Compensation |
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WC Assessment Form (WCC10)
Workers' Compensation |
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| For Insurance Companies, Self-Insurers & Group Funds / Requires Microsoft Word | ||
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WC Cause of Injury Codes
Workers' Compensation |
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WC Claim Summary Form (Form WC 4)
Workers' Compensation |
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WC Combination Supplementary & Claim Summary Form
Workers' Compensation |
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WC Combination Supplementary & Claim Summary Form
Workers' Compensation |
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| Requires Microsoft Word | ||
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WC Corporate Exclusions/Inclusions
Workers' Compensation |
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WC Drug Free Certification of Drug Free Workplace
Workers' Compensation |
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WC First Report of Injury (WC Form 2 9/2006)
Workers' Compensation |
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WC First Report of Injury (WC Form 2 Rev. 9/2006) *Requires Microsoft Word
Workers' Compensation |
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WC NAICS Industry codes
Workers' Compensation |
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WC Nature of Injury Codes
Workers' Compensation |
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WC Notice of Cancellation (Form WC )
Workers' Compensation |
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WC Notice of Coverage (Form WC 8)
Workers' Compensation |
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WC Order Form
Workers' Compensation |
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WC Part of Body Injury Codes
Workers' Compensation |
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WC Re-Certification of Drug Free Workplace
Workers' Compensation |
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WC Supplementary Report (WC Form 3)
Workers' Compensation |
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WEEKLY REQUEST FOR ALLOWANCE BY WORKER IN TRAINING
Unemployment Compensation |
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