Jump to the Menu Area Jump to the Content Area
Home Open Menu
KANSAS.GOV

FORMS

All required forms should be completed and returned to the Kansas Unemployment Contact Center as indicated on the form. Many of the forms can be completed online and submitted by using the "Submit" button at the bottom of the form. The light blue boxes indicate the fillable areas. Print a copy of the completed form for your records. Note: If you use the "Submit" button, your statement will be considered signed when received. If faxing the form, be sure to print all the pages and send both sides of the form if you have written information on the back of the page. If you choose not to submit the form electronically, be sure to sign it before sending it to the Contact Center.

Able and Available Statements

Able and Available Statement: Medical Condition or Workers Compensation,  K-BEN 31 En Español,  K-BEN 31 S Availability Statement,  K-BEN 32 En Español,  K-BEN 31-SA

Tax Withholding

Income Tax Withholding Agreement, K-BEN 233 Contrato Para Retener Impuestos De Ingresos Federales y/o Estatales De Los Beneficios De Seguro De Desempleo, K-BEN 233-A

Other

Alien Statement  K-BEN 3117 En Español,  K-BEN 3117-A Bonus Pay – Claimant K-BEN 3121 Claimant Separation Statement,  K-BEN 3110 Do These Activities to Get Paid Benefits,  K-BEN 992 Health Care Provider's Certification,  K-BEN 312 Job Refusal Statement,  K-BEN 3118-A Labor Dispute Statement,  K-BEN 314 My Reemployment Plan,  K-BEN 990 En Español, K-BEN 990-A Officer of Corporation Statement,  K-BEN 3120-B Pension Statement,  K-BEN 3113 Reasonable Assurance Statement,  K-BEN 3136 Request for Disclosure of Tax/Benefit Information,  K-RM 002 Request for Information - Ability to Work,  K-BEN 5691 School Attendance,  K-BEN 317 Self Employment Statement,  K-BEN 3120-A Separation Pay Statement,  K-BEN 3119 Substitute School Employee Statement,  K-BEN 3137 Warn Act Award – Claimant,  K-BEN 3115 Worked Full-Time,  K-BEN 230 Work Search Activity Log,  K-BEN 987

RETURN HOME