The Affidavit for Correction of Form 1099-G is the affidavit form that the Maryland Department of Labor, Division of Unemployment Insurance, uses when a claimant's 1099-G does not match the unemployment insurance benefits actually received. You sign it under penalty of perjury and send it by mail with a copy of your photo identification. On FillingPDF you can fill out the form online and download or print the completed PDF; the agency publishes the original at labor.maryland.gov and receives it only by mail.
Last updated
What is Affidavit for Correction of Form 1099-G – Maryland?
The Affidavit for Correction of Form 1099-G is a sworn statement, issued by the Maryland Department of Labor's Division of Unemployment Insurance, in which a claimant says that a 1099-G showing unemployment insurance benefits contains an error and explains what the error is.
By signing, you state that you did receive a 1099-G indicating that you received unemployment insurance benefits, but that there was an error on it. The form asks you to choose the basis for your request for a corrected 1099-G and to add details:
- the amount of benefits listed is incorrect, and you give the amount you received;
- you did not apply for or receive unemployment insurance benefits in the calendar year;
- you applied but did not receive any benefits in the calendar year;
- you received benefits, but the dates are wrong, and you give the correct dates;
- another circumstance, explained with all relevant dates.
The certification is made under penalty of perjury and under the identity theft and identity fraud laws of the United States and the State of Maryland. The agency decides based on what you provide. This is a single-purpose affidavit for 1099-G errors, not a general-purpose affidavit, and it is not the Request for Investigation of Unemployment Insurance Fraud form that the agency's fraud page names for reporting suspected fraud.
Who needs to file Affidavit for Correction of Form 1099-G – Maryland?
Maryland unemployment insurance claimants who received a 1099-G that is wrong, or who received one by mistake because they did not receive benefits in Maryland during the previous year, complete this affidavit. The form covers five situations: an incorrect benefit amount, no application or benefits at all in the year, an application with no benefits paid, incorrect benefit dates, and other circumstances you explain.
The person named in the certification must be the individual completing the affidavit. The form states that you certify under identity theft and identity fraud laws that you are that individual, so the claimant prints their own full name and signs.
Do not use this affidavit if you are an employer who believes a fraudulent claim was charged to your account; the agency's fraud page describes a benefit charge protest in the Maryland Unemployment Insurance Portal (BEACON) for that. If you suspect your identity was used to apply for benefits, the same page says to email or call 667-207-6520 to start an investigation.
When to file Affidavit for Correction of Form 1099-G – Maryland
Complete the affidavit after you receive a 1099-G that is incorrect, or that you believe you received by mistake because you did not receive unemployment insurance benefits in Maryland during the previous year. The form prints no filing deadline and no processing time. If you are unsure about timing or the status of a correction, call a claims agent at 667-207-6520, Monday to Friday, 8 a.m. to 4 p.m. The Department says it will contact you by e-mail or telephone if it has questions about your affidavit.
Documents you need
- A copy of your photo identification, sent with the completed affidavit to Benefit Payment Control.
How to fill out Affidavit for Correction of Form 1099-G – Maryland
Enter your name
Under CLAIMANT INFORMATION, enter your First Name, Last Name and Middle Initial.
Enter your address
Fill in Address, City, State and Zip code with the address where you receive mail.
Enter your identification number
Enter your Claimant Identification Number or the Last Four Digits of your Social Security Number in the single field the form provides.
Add e-mail and telephone
Enter your Claimant E-mail Address and Claimant Telephone Number. The Department uses them to contact you if it has questions.
Choose the basis for your request
Select the one statement that matches your situation: incorrect amount, no application or benefits, applied but received nothing, incorrect dates, or Other. Write the calendar year where the statement has a blank for it.
Add the amount, dates or details
For an incorrect amount, enter the amount you received. For incorrect dates, enter the correct dates. For Other, explain the circumstances with all relevant dates in the area provided.
Print your name in the certification
In the CERTIFICATION, print your full name on the line after "I,". You are declaring under penalty of perjury that the statements are true and correct.
Sign and date the affidavit
Enter your Signature and the Date. The certification states that false statements or withholding of facts carry penalties.
Prepare your photo identification
Make a copy of your photo identification to send with the affidavit.
Review, download and print the PDF
Check that the year, amount or dates and your contact details are correct. Download or print the completed PDF from FillingPDF, then mail it with the ID copy as described under How to submit.
How to submit Affidavit for Correction of Form 1099-G – Maryland
The affidavit is submitted by mail. The form and the agency's fraud page name no other channel.
- By mail: send the signed and dated affidavit with a copy of your photo identification to Attn: Benefit Payment Control, 100 South Charles Street, Tower 1, Baltimore, MD 21201.
The Department will contact you by e-mail or telephone if there are questions, so give a working e-mail address and telephone number on the form. Do not send sensitive details such as your Social Security number by e-mail; the agency says to call the Division at 667-207-6520, Monday through Friday, 8 a.m. to 4 p.m., for questions that require sharing them. FillingPDF lets you fill out and download the PDF; submission follows the mailing channel above.
Common mistakes to avoid
- Mailing the affidavit without a copy of your photo identification, which the form says must be submitted with it.
- Sending it to an address other than Attn: Benefit Payment Control, 100 South Charles Street, Tower 1, Baltimore, MD 21201.
- Leaving the calendar year blank in the option you choose, so the Department cannot tell which 1099-G is disputed.
- Choosing the incorrect-amount option without writing the amount of benefits you actually received.
- Choosing the incorrect-dates option without listing the correct dates for the benefits received.
- Using the Other option without explaining the circumstances with all relevant dates.
- Sending the form unsigned or undated; the certification requires both a signature and a date.
- Printing a name in the certification that is not the claimant's own; you certify that you are the individual completing the affidavit.
- Using this affidavit to report suspected identity theft instead of contacting the Division at 667-207-6520 to start an investigation.
Frequently asked questions
What is the Maryland affidavit form for an incorrect 1099-G?
It is the Affidavit for Correction of Form 1099-G from the Maryland Department of Labor's Division of Unemployment Insurance. You sign it under penalty of perjury to say that a 1099-G you received shows an error, such as a wrong amount or benefits you never received.
Who should complete the Affidavit for Correction of Form 1099-G?
Claimants whose 1099-G is incorrect, or who received a 1099-G by mistake because they did not receive unemployment insurance benefits in Maryland during the previous year. Employers disputing a fraudulent claim use a benefit charge protest in BEACON instead.
Where do I mail the Maryland 1099-G affidavit?
Mail it to Attn: Benefit Payment Control, 100 South Charles Street, Tower 1, Baltimore, MD 21201. Include a copy of your photo identification. The form names no other submission channel.
What do I need to send with the affidavit?
A copy of your photo identification, along with the signed and dated affidavit. The form lists no other attachment. Choose the basis for your request and add the amount, dates or explanation it asks for.
Can I fill out the affidavit online?
You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not send the affidavit to Maryland; you mail the completed form to Benefit Payment Control yourself.
What if I never applied for unemployment benefits but got a 1099-G?
Choose the statement that you did not apply for or receive unemployment insurance benefits in the calendar year and enter the year. If you suspect your identity was used, the agency also says to email or call 667-207-6520 to start an investigation.
Does the Department contact me after I send the affidavit?
Yes, if it has questions. The form says the Department will contact you by e-mail or telephone, so enter both on the form. A decision is made based on the information you provide.
What happens if I make a false statement on the affidavit?
The form says the law provides penalties for false statements or withholding of facts. If your statements are proven false after filing, it is considered fraud and remedies will be pursued as the law allows.
Ready to fill out Affidavit for Correction of Form 1099-G – Maryland?
Fill out Affidavit for Correction of Form 1099-G – Maryland now