Request to Return Payments

If you would like to return funds you have removed from your debit card or received by direct deposit please follow this link for information on how to return those funds: https://www.dol.state.ga.us/public/uiben/opach/enroll

This application is only for individuals who received unemployment benefits by a debit card as a result of a claim filed by the individual or an employer who filed on the individual's behalf to request electronic return of benefits to the Georgia Department of Labor (GDOL).

Please provide the information requested below to authorize the GDOL to retrieve the benefits paid.

* Required

First Name: *

Last Name: *

Last 4-digits of Social Security Number: *

Mailing Street Address: *

Mailing City: *

Mailing State: *

Mailing Zip Code: *

Contact Number: *

Email Address: *

Did you PIN or register the debit card? *

Yes No Did not receive a card

Did you withdraw or spend any of the benefit payments? *

Yes No

Do you wish to return the benefits paid to the Georgia Department of Labor? *

Yes No

If yes:

Additional information:

(Enter up to 1000 characters.)

Acknowledgement:

* By checking the box that I am the individual whose information I have entered above. I authorize GDOL to remove all funds remaining on the debit card account.