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Nebraska Department of Labor Unemployment Insurance Employer Services


Application for Unemployment Insurance Account Number
Step 1Step 2Step 3
Organization Name, Address, etc.
*Legal Name
(Individual, Partnership, Corporation, LLC Name)
Attention
Trade Name
(Doing Business As - List All Names)
*Mailing Address *Phone Number Business Website
*City *State *Zip Code Plus 4

*The physical location of this business in Nebraska is: select one
If Out of State employer, are services of workers performed in Nebraska?
*Are you an employee leasing company/PEO?
If yes, your client's Nebraska workers and wages must be reported under their established Nebraska Unemployment Insurance account or you must complete this application with your client's information to establish an account in Nebraska.



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