MDES - Self-Employment Assistance Program Application

To apply on-line, please complete the online form below.

Or, for a printable, fillable form, click here.

Claimant's Name

Address

City

State

Zip Code

Phone Number

E-mail Address

Business Name

Business Address

This information is needed in order to make a decision about your eligibility for self-employment assistance benefits - Please provide the requested information. You may be required to provide additional information after your application is reviewed. Providing false or misleading information may result in disqualification of eligibility or a denial of benefits in accordance with Mississippi Department of Employment Security unemployment insurance laws.

For SEAP information and eligibility requirements, click here.

To report any changes in your information as required, please email msseap@mdes.ms.gov

Self-Employment Assistance Program Application

To apply on-line, please complete the online form below.

Self-Employment Assistance Program Application

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