CTDOL ID Theft Report Form

ID Theft Report Form

I think I may be a victim of unemployment fraud due to Identity Theft
Criminal activity within the unemployment system, using data obtained by fraudsters in prior nationwide breaches of various companies, has been a nationwide issue and the Connecticut Department of Labor has taken this issue seriously. The agency has been proactive in protecting your personal information by implementing safeguards against these sophisticated fraud schemes.

However, if you feel you may be a victim of unemployment fraud due to identity theft, please complete the following form by providing the required information. Our Integrity Unit will review your submission and contact you in the upcoming weeks.

I believe I may be a victim of unemployment fraud due to identity theft.
I received paperwork from the Department of Labor in the mail stating I filed for unemployment benefits however I never filed. *
I received a UC-1099G tax form stating I collected unemployment benefits. I did not file for unemployment benefits in 2020. *
Full Name: *

First Name Last Name
Address *

Street Address

Street Address Line 2

State

Zip Code
City *
Last four of SSN: *
(format = #### no dashes please)
Primary Email *
example@example.com
Contact Phone : *
Please verify that you are human *
Should be Empty: