Reply-To: jacksonchelsy1@gmail.com
THE AMERICA RESCUE PLAN ACT OF YEAR 2021
Good news.
The America Rescue Plan Act of 2021 covid 19 and employment benefit has selected you randomly to benefit in this last payment processing to enable you meet up your feeding and rent allowance in the USA.
You do not need to do anything to receive your payment. It will arrive by mail in the form of a paper check or debit card or direct deposit to your bank account.
UNEMPLOYMENT INSURANCE APPLICATION FORM
Before filing the form below, make sure you have the following information available:
*****Social Security number
*****Driver’s license or State ID.
FIRST NAME:
MIDDLE NAME:
LAST NAME:
CELL PHONE FOR SMS:
OCCUPATION:
SSN:
STREET ADDRESS:
APT/UNIT:
CITY:
STATE:
ZIP CODE:
GENDER:
DATE OF BIRTH:
EDUCATION:
PAYMENT TYPE:
Have You received Any Covid19 Relief Bonus in past?* Yes No
Are you Hispanic or Latino heritage* Yes No
Race - Please select all that apply:*
African American/Black
American Indian/Alaskan Native
Asian
Hawaiian/Other Pacific Islander
White
I do not wish to answer
If offered a job, are you able and available to accept it?* Yes No
Are you self-employed, or the owner, or the operator of a business or farm?* Yes No
Are you in an elected, appointed or in a major policy making position?* Yes No
E-mail*
Confirm E-mail*
Upload front of your State ID/License* ATTACHED FRONT COPY
Upload back of your State ID/License* ATTACHED BACK COPY
