Wisconsin Labor and Industry Review Commission

Form For Electronic Filing of Petition for Commission Review (Unemployment Insurance)

To file a petition for review electronically, complete this form and follow the filing instructions below. Fields marked with an asterisk (*) are mandatory and must be completed.

PLEASE NOTE: This form may NOT be used to appeal an Initial Determination. It may ONLY be used to appeal an Administrative Law Judge's Appeal Tribunal Decision.

I hereby petition for review by the Labor and Industry Review Commission of the ALJ's decision in the following Unemployment Insurance matter:

(Instructions are shown to the right of each form field)

Petition Information

Hearing Number(s):* Enter the hearing number(s) shown on the first page of the Appeal Tribunal Decision.

Date of Decision:* Enter the date shown in the "Dated and Mailed" box on the first page of the Appeal Tribunal Decision.

Statement on Timeliness of Petition: If this petition is not being filed by the date specified on the front of the Appeal Tribunal Decision, provide a specific and complete explanation why the petition is late.

Form will not accept a submit if it exceeds 700 characters.

characters remaining.

Employee: Enter the name of the employee shown on the first page of the Appeal Tribunal Decision (if no employee name is shown on the ATD, this box may be left blank).

Employer: Enter the name of the employer shown on the first page of the Appeal Tribunal Decision (if no employer name is shown on the ATD, this box may be left blank).

Statement of Reasons for Petition: A statement of the reasons this petition is being filed may be entered here. (Optional)

Form will not accept a submit if it exceeds 700 characters.

characters remaining.

Information about the person filing this petition:

Your Name:* The person filing this petition should enter his or her name here, and indicate their role.

Address:* The person filing this petition should enter his or her mailing address here.

City:* The person filing this petition should enter his or her city here.

State:* The person filing this petition should enter his or her state here.

Zip Code:* The person filing this petition should enter his or her zip code here.

Telephone: (Optional)

Email: A confirmation message will be sent to any e-mail address entered here. (Optional)

Filing instructions:

TO FILE A PETITION ONLINE USING THIS FORM PLEASE KEEP YOUR REASONS FOR PETITION AND STATEMENT REGARDING TIMELINESS OF PETITION UNDER 700 CHARACTERS EACH

PLEASE NOTE: This form may NOT be used to appeal an Initial Determination. It may ONLY be used to appeal an Administrative Law Judge's Appeal Tribunal Decision.
Before you proceed, check the information entered above to ensure that it is complete and correct.
After you click the "File Petition" button below, you should see a confirmation page. Your petition is not filed until you see this confirmation page. If you do NOT see the confirmation page, or you are for any other reason unable to complete the electronic filing process, you must use another means to file your petition. You should print and keep a copy of the confirmation page. If there is a question about whether or when you filed a petition, you may be asked to produce a copy of that page.
If you have questions about how to complete or use this form, you may contact the commission by telephone during normal business hours (7:45 AM to 4:30 PM), at 608-266-9850.
To file your petition, click on the "FILE PETITION" button below: