To maintain your eligibility requirements for unemployment insurance benefits, a review of your work search record is required. When instructed, you must complete the items below and fax this form to (225) 219-1185 or mail this form to the Louisiana  Workforce Commission, Adjudication Support Unit, P. O. Box 91253, Baton Rouge, LA 70821-1253.  This form is semi-interactive and may be filled out online, then printed and mailed.  Failure to return this form timely could result in your being disqualified for benefits.