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I certify that all information I have provided is correct and complete. I acknowledge
that false statements are punishable pursuant to 18 PA.C.S. §4904, relating to
unsworn falsification to authorities.
Providing your SSN is required under the authority of the Internal Revenue Service
code and the 1964 SSN Act. The SSN is mandatory for filing unemployment
compensation; your SSN will be used to report the amount of any compensation you
get to the IRS and income may be taxable. Your SSN is also used to identify your
claim for statistical purposes and to make sure you are eligible for unemployment
compensation and other public assistance benefits.
I certify that all the information I have provided in this claim is true to the best of my
knowledge. The Department of Labor and Industry routinely exchanges information
with other federal, state and local agencies. Computer resources are used to detect
illegal reception of benefits and to verify the information provided. Providing true
information ensures the accuracy of your claim; providing incorrect information or
providing information on behalf of another person may be considered fraud.
If you give false information to the Department of Labor & Industry (department) or
withhold information to obtain UC, you may be criminally prosecuted under various
provisions of Pennsylvania law: 18 Pa.CS §4904 (unsworn falsification to
authorities), 18 Pa.CS §3922 (theft by deception) and 43 PS §871 (false statements
or representations to obtain or increase compensation). ). If you are prosecuted, you
may be subject to a fine, imprisonment, restitution, garnishment of federal tax
refunds and loss of future benefits.