You are on page 1of 2

Job Search Log

NAME: ID: Keep this document for your records


INSTRUCTIONS: Please use dark ink only. Keep this Job Search Log for your records - do not send it to us unless we ask for it. You must complete this log for each
week you claim unemployment benefits. You must have a combined total of three employer contacts or approved job-search activities each week. You can get more logs at your
local WorkSource office or online at www.esd.wa.gov/job-search-log. If you apply online or respond to a newspaper ad, please attach a copy of the confirmation notice or ad.
Refer to pages 23-24 in your Unemployment Claims Kit for further instructions on completing this log.

If we select you for an interview to review your job search activities, please bring proof of your identity. We may review your logs any time up to 60 days past the end of your
benefit year or up to 30 days after receiving any benefits, whichever is later. We may call the employers listed to verify that you looked for work. Providing false information is
fraud that can result in a denial of your unemployment benefits and additional penalties.
Employer contacts and job search activities
How contact was made Contact person, job Type of contact
Date of contact Business name with complete mailing address/web address or
(Include phone number, complete e-mail address, or reference number, or (Include position applied for or name of
M/D/Y WorkSource office
confirmation for all contacts) confirmation notice approved WorkSource activity if applicable)
Business/WorkSource office name
In person Online Other Application / resume Inquiry
CONTACT 1

Interview WorkSource activity


Street, P.O. box or web address Phone: (……….)……………………………………..

Fax: (……….)………………………………………...
City, state and zip code
E-mail: ………………………………………………..

In person Online Other Application / resume Inquiry


CONTACT 2

Interview WorkSource activity


Phone: (……….)……………………………………..
Fax: (……….)………………………………………...

E-mail: ………………………………………………..

In person Online Other Application / resume Inquiry


CONTACT 3

Interview WorkSource activity


Phone: (……….)……………………………………..

Fax: (……….)………………………………………...

E-mail: ………………………………………………..

In person Online Other Application / resume Inquiry


CONTACT 4

Interview WorkSource activity


Phone: (……….)……………………………………..

Fax: (……….)………………………………………...

E-mail: ………………………………………………..

In person Online Other Application / resume Inquiry


CONTACT 5

Interview WorkSource activity


Phone: (……….)……………………………………..

Fax: (……….)………………………………………...

E-mail: ………………………………………………..

In person Online Other Application / resume Inquiry


CONTACT 6

Interview WorkSource activity


Phone: (……….)……………………………………..
Fax: (……….)………………………………………...

E-mail: ………………………………………………..

For The Employment Security Department is an equal opportunity employer and provider of programs and services. Auxiliary aids and
Week being verified Reschedule WS office name or # TeleCenter # Staff initials
services are available upon request to persons with disabilities. Auxiliary aids may include qualified interpreters and telecommunication
official devices (TTY) for hearing or speech impaired individuals. Individuals with limited English proficiency may request interpretive services
use only free of charge to the customer in order to conduct business with the department.
EMS 10313 . CC 7540-032-823 . Rev 8/10
NAME: .............................................................................................. ID: .................................................................
How contact was made Contact person, job Type of contact
Date of contact Business name with complete mailing address/web address or
(Include phone number, complete e-mail address, or reference number, or (Include position applied for or name of
M/D/Y WorkSource office
confirmation for all contacts) confirmation notice approved WorkSource activity if applicable)
Business/WorkSource office name
In person Online Other Application / resume Inquiry
CONTACT 7

Interview WorkSource activity


Street, P.O. box or web address Phone: (……….)……………………………………..
Fax: (……….)………………………………………...
City, state and zip code
E-mail: ………………………………………………..

In person Online Other Application / resume Inquiry


CONTACT 8

Interview WorkSource activity


Phone: (……….)……………………………………..

Fax: (……….)………………………………………...

E-mail: ………………………………………………..

In person Online Other Application / resume Inquiry


CONTACT 9

Interview WorkSource activity


Phone: (……….)……………………………………..

Fax: (……….)………………………………………...

E-mail: ………………………………………………..

In person Online Other Application / resume Inquiry


CONTACT 10

Interview WorkSource activity


Phone: (……….)……………………………………..

Fax: (……….)………………………………………...

E-mail: ………………………………………………..

In person Online Other Application / resume Inquiry


CONTACT 11

Interview WorkSource activity


Phone: (……….)……………………………………..

Fax: (……….)………………………………………...

E-mail: ………………………………………………..

In person Online Other Application / resume Inquiry


CONTACT 12

Interview WorkSource activity


Phone: (……….)……………………………………..

Fax: (……….)………………………………………...
E-mail: ………………………………………………..

In person Online Other Application / resume Inquiry


CONTACT 13

Interview WorkSource activity


Phone: (……….)……………………………………..

Fax: (……….)………………………………………...

E-mail: ………………………………………………..

In person Online Other Application / resume Inquiry


CONTACT 14

Interview WorkSource activity


Phone: (……….)……………………………………..

Fax: (……….)………………………………………...

E-mail: ………………………………………………..

In person Online Other Application / resume Inquiry


CONTACT 15

Interview WorkSource activity


Phone: (……….)……………………………………..
Fax: (……….)………………………………………...

E-mail: ………………………………………………..