Interstate Unemployment Benefits Transfer Request Form

Interstate Unemployment Benefits Transfer Request Form
Submit this form to request the transfer of your unemployment benefits claim from one state to another. Please provide accurate information to ensure timely processing.
Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Current State Where Claim Was Filed
State to Transfer Benefits To
Claim Reference Number (if available)
Date of Original Claim Filing
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Reason for Transfer Request
Current Mailing Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Should be Empty: