**PLEASE NOTE: This form is only applicable for people who live in 161st District. To find out in which district you live and how to reach out to your state representative, please click here.
Under certain circumstances, our office can send a Legislative Inquiry to the Department of Labor and Industry so that your UC claim can be reviewed by a UC investigator.
** If your claim is under review, appeal, or adjudication do not fill out this form, our office cannot submit a legislative inquiry. Please visit: Appeals (pa.gov) **
Before you complete the form, check this list of issues and links to resolve them:
If your claim issue is not listed above, please complete and submit this form:
If yes, list the date(s) of the week(s) you filed but did not receive payment and, if you worked during any of those weeks, your earnings for each week. If you have not yet filed a weekly claim, enter “NONE.” *