Fillable Record of Work Search (Michigan)

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Record of Work Search (Michigan)

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STATE OF MICHIGAN
GRETCHEN WHITMER DEPARTMENT OF LABOR AND ECONOMIC OPPORTUNITY JEFF DONOFRIO
GOVERNOR UNEMPLOYMENT INSURANCE AGENCY DIRECTOR
Authorized by
MCL 421.1 et seq.
UIA 1583
(Rev. 03-19)
•
Record of Work Search
You can submit details of your work search when reporting for your bi-weekly certications in your
MiWAM account or by submitting this form or in alternative format such as a spreadsheet or hand written
on paper, as long as it includes the information required. Below are the instructions to complete the
reverse side.
You must look for work by making at least two job contacts per week. Keep a record of the following
information:
• Week Ending Date - This date is for the week you are claiming. The date starts on Sunday and
ends on Saturday. Write the Saturday date for each week.
• Date of Contact - The date of your work search must fall within the week ending date (Sunday
through Saturday) for each week.
• Name of Employer - Write the name, if known, of the employer, employment service or agency
that was contacted. If the contact was made online and the employer was not specied, enter the
name of the search engine or job posting number.
• Employer Address/Telephone Number/ Website address - Enter the physical address or
location of the position applied for. If the contact was made by telephone, enter the phone number
used. If the contact was made online and the address/location is unknown, enter the website
address.
• Method of Contact - Enter how contact was made (e.g., in person, phone, mail, fax, email,
online)
Inform UIA of your Work Search:
• Your work search is due every four weeks.
• Work search contacts can be entered at the time of bi-weekly certication in MiWAM, by using
Form UIA 1583, Record of Work Search, or an alternative format such as a spreadsheet or hand
written on paper, as long as it includes the information required.
• You can submit your work search by fax to 1-517-636-0427, by mail to Unemployment Insurance
Agency, Multi Service Center, 9023 Joseph Campau, Hamtramck, MI 48212 or drop it o in
person at any UIA Local Oce.
• When submitting your work search, include your name and Social Security Number on each page.
Important
• Keep a copy for your records.
• Your work search is subject to audit and verication.
• Failing to submit timely and accurate work search forms may prevent payment of your UI
benets.
If your address changes it is important to update it with the Unemployment Insurance Agency.
If you have questions, you may contact us through your MiWAM account or by calling, 1-866-500-0017.
For telephone or Local Oce hours of operation, visit www.michigan.gov/uia. TTY service is available
at 1-866-366-0004.
UIA 1583
(Rev. 03-19)
LEO is an equal opportunity employer/program.
•
*015831903*
Date Mailed/Faxed: _____________________
Name: _________________________________________________________
--
Enter your Social Security Number
You must contact a minimum of two employers within each week and report the details for each work search. You can submit your record of work search
through your MiWAM account, by fax, by mail or in person to an Unemployment Insurance Local Oce. Computer and fax services are available at any
Michigan Works! Agency (MWA) Service Centers. Your search is subject to audit and verication. Keep a copy for your records. See instructions on front
side.
Certication: I certify that the information I have reported is true and correct. I understand that if I intentionally make a false statement, misrepresent facts
or conceal material information to reduce or prevent benets, I may be required to repay benets, be charged damages and could be subject to criminal
prosecution.
__________________________________ __________________ _________________
Signature Date Telephone Number
Date of Contact Name of Employer
Employer Address/
Telephone Number/
Website Address
Method of
Contact
Example:
First Week Ending Date: 7/7/2018 _____________ (Enter a Saturday date)
07/02/18 ABC Company 517-555-6789
In Person Mail
Telephone Fax
Internet Other
07/05/18 XYZ Construction Company www.xyzconstruct.com
In Person Mail
Telephone Fax
Internet Other
First Week Ending Date: _______________________ (Enter a Saturday date)
In Person Mail
Telephone Fax
Internet Other
In Person Mail
Telephone Fax
Internet Other
Second Week Ending Date: _____________________ (Enter a Saturday date)
In Person Mail
Telephone Fax
Internet Other
In Person Mail
Telephone Fax
Internet Other
x
x
•
RECORD OF WORK SEARCH
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Record of Work Search (Michigan)

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Completed 7 June 2021

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