Unemployment Insurance Benefits Missing/Lost/Stolen Checks

Note: If you have checked your “Claim Information” and find that a payment was issued and the amount is not showing up on your EPC/Debit Card or in your checking/savings account (if you’ve chosen to receive payments via direct deposit); you must contact the bank that issued your EPC/Debit Card or your personal bank/credit union (for direct deposit). Please make sure that you check the information you've entered on the form before sending so we can investigate and contact you with our findings. If you are receiving UI Benefits from a state other than Arizona, you must contact that state.

First Name *

Middle Initial

Last Name *

Last Four Digits of Social Security Number *

XXX-XX-

DOB *

Month

Day

Year

Phone

Email *

Address 1

Address 2

City

State

Zip

Date the Check/Payment Was Issued (if known mm/dd/yy)

Month

Day

Year

Dollar Amount of the Missing Check/Payment: (example: 145.00)

$

The Check/Payment Was

Not Received

Lost

Stolen

Comments

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Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. The process for requesting a reasonable modification can be found at Equal Opportunity and Reasonable Modification.

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Unemployment Insurance Benefits Missing/Lost/Stolen Checks

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Unemployment Insurance Benefits Missing/Lost/Stolen Checks

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