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DE 1275A Rev. 43 (11-04) (INTERNET) Cover + 35 Pages CU A GUIDE TO BENEFITS AND EMPLOYMENT SERVICES

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  • DE 1275A Rev. 43 (11-04) (INTERNET) Cover + 35 Pages CU

    A GUIDE TOBENEFITS ANDEMPLOYMENT

    SERVICES

  • READ THIS HANDBOOK COMPLETELY ANDCAREFULLY

    Failure to follow the instructions in thishandbook, make timely inquiries whennecessary, report as directed, file requireddocuments in a timely manner, or file claim formsas directed may result in delay or loss of yourunemployment benefits.

    Do not rely on advice from friends or relatives. Ifyou do not understand something or have aproblem with your claim, call the EmploymentDevelopment Department (EDD), UnemploymentInsurance (UI) office.If you want or need in-person assistance with UI,call our toll-free telephone number for directionsto the nearest EDD location.

    EDD UI Toll-Free Telephone NumbersInside California:

    English 1-800-300-5616Spanish 1-800-326-8937Cantonese 1-800-547-3506Mandarin 1-866-303-0706Vietnamese 1-800-547-2058

    Outside California but within the United States,Canada, Puerto Rico, or the Virgin Islands:

    1-800-250-3913

    TTY (Non Voice) 1-800-815-9387EDD Web site for general information:

    www.edd.ca.gov

    File your UI claim the fast, easy way the eApply4UI way!

    Go to the eApply4UI Internet applicationat www.edd.ca.gov/eapply4ui

    DE 1275A Rev. 43 (11-04) (INTERNET) Inside Cover + 35 Pages CU

  • TABLE OF CONTENTS

    Introduction ..................................................................................... 1

    Notice of Unemployment Insurance Award ................................... 2

    Explanation of Items on the Notice of UnemploymentInsurance Award .......................................................................... 3

    Cancelling a Claim .......................................................................... 14

    Waiting Period ................................................................................. 14

    Claiming Unemployment Insurance Benefits................................. 15

    Explanation of Questions on the Claim Form ................................ 16

    Unemployment Insurance Checks ................................................. 20

    Unemployment Insurance Eligibility Requirements ....................... 21

    Penalties ......................................................................................... 22

    Overpayments ................................................................................ 22

    Appealing an EDD Notice ............................................................... 23

    Requesting Copies of Your Unemployment InsuranceDocuments .................................................................................. 24

    Training and Other Special Programs

    California Training Benefits .......................................................... 24

    CTB Training Extension Claims ................................................... 25

    Trade Adjustment Assistance (TAA) Program ............................ 25North American Free Trade Agreement Transitional

    Adjustment Assistance (NTAA) ................................................ 26Federal-State Extended Benefits Program................................. 27

    Disaster Unemployment Assistance (DUA) ................................ 27Work Sharing (WS) ..................................................................... 27Partial Claims............................................................................... 28

    DE 1275A Rev. 43 (11-04) (INTERNET) i + 35 Pages CU

  • Other EDD Services

    Job Services ................................................................................ 28

    Reemployment Services ............................................................. 28

    One-Stop Services ...................................................................... 29

    Americas Workforce Network (AWN).......................................... 29Disability Insurance (DI) .............................................................. 30

    Other Important Information

    Child Support Intercept ............................................................... 30

    Fraud Prevention and Detection ................................................. 31

    Verification of Right to Work ........................................................ 31

    Verification of Social Security Account Number.......................... 32

    Confidentiality .............................................................................. 33

    Privacy Act Statement ................................................................. 33

    Telephone Services ..................................................................... 33

    Telephone Services for the Deaf, Hard of Hearing, andSpeech-Disabled ...................................................................... 34

    Internet Services ......................................................................... 34

    Federal Income Tax and UnemploymentInsurance Benefits ................................................................... 35

    Voluntary Federal Income Tax Withholding................................. 35

    1099G .......................................................................................... 35

    Americans With Disabilities Statement ........................... Back Cover

    Need help looking for a good job?Your local Job Service provides services that can assist you in findingemployment. There are no fees for these services. Refer to the Other

    EDD Services section of this handbook under Job Services.

    DE 1275A Rev. 43 (11-04) (INTERNET) ii + 35 Pages CU

  • INTRODUCTION

    This booklet provides a general overview of the UnemploymentInsurance (UI) program. For specific information about your claim,call the Employment Development Department, UnemploymentInsurance (EDD UI) toll free telephone number below.The UI program provides financial benefits for workers who areunemployed through no fault of their own, who are able to, availablefor, and actively seeking work as instructed. Eligibility for receivingbenefits is set by law. The Employment Development Department(EDD) administers these laws. You can find Californias UI eligibilityrequirements in the Unemployment Insurance Code.

    In California, no deduction is made from the workers wages tofinance UI. It is paid entirely by employers.

    Your claim is subject to periodic quality control and benefit auditreviews. There are severe administrative and/or criminal penaltiesimposed on individuals found guilty of UI fraud. Claimants reportingfalse information to obtain UI benefits may be subject to thosepenalties.

    EDD UI Toll-Free Telephone Numbers Inside California:English 1-800-300-5616Spanish 1-800-326-8937Cantonese 1-800-547-3506Mandarin 1-866-303-0706Vietnamese 1-800-547-2058

    Outside California but within the United States,Canada, Puerto Rico, or the Virgin Islands:

    1-800-250-3913

    TTY (Non Voice) 1-800-815-9387

    EDD Web site for general information:www.edd.ca.gov

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 1 of 35 CU

  • The Notice of Unemployment Insurance Award provides informationabout when your claim begins, your award and the earnings uponwhich the claim is based. It also gives instructions regarding yourrequirement to seek work. Each of the numbered items is explainedon the following pages.

    Notice of Unemployment Insurance Award Sample

    NOTICE OF UNEMPLOYMENT INSURANCE AWARD

    YOUR CLAIM FORUNEMPLOYMENT INSURANCE BENEFITS

    HAS BEEN FILED

    DE 429/Z/ Rev. 2 (7-04) (INTERNET) Page 1 of 2 CU

    EDD Call CenterPO BoxCity CA Zip Code

    Mail Date: 00/00/0000SSN: 000-00-0000

    EDD Telephone Numbers:English (800) 300-5616Spanish (800) 326-8937Cantonese (800) 547-3506Mandarin (866) 303-0706Vietnamese (800) 547-2058Outside CA (800) 250-3913TTY (non voice) (800) 815-9387

    Claimants NameClaimants AddressCity CA Zip Code

    NOTICE OF UNEMPLOYMENT INSURANCE AWARD

    1. Claim Beginning Date: 00/00/0000

    3. Maximum Benefit Amount: $0000

    5. Total Wages: 00,000.00

    7. This item does not apply to your claim.

    2. Claim Ending Date: 00/00/0000

    4. Weekly Benefit Amount: $000

    6. Highest Quarter Earnings: 0,000.00

    8. You must look for full time work each week. Please see your handbook, A Guide to Benefits andEmployment Services, DE 1275A, for more information about looking for work.

    9. This item does not apply to your claim.

    10. Employee Name 11. Employee Wages for the Quarter Ending: 12. Employer NameMonth/Year Month/Year Month/Year Month/year

    Claimants Name 0,000 0,000 ABC COClaimants Name 0,000 0,000 XYZ CO

    13. Totals: 0,000 0,000 0,000 0,000

    Important Information On Next Page

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 2 of 35 CU

  • It is important to check the Notice of UnemploymentInsurance Award carefully to make sure that all employersyou worked for during the quarters shown are listed.

    If you told EDD that you worked for a federal agency or inanother state when you filed your claim, your wageinformation is being requested from that agency or state.

    You will receive an amended notice when the federal wagesor other state's wages have been added. If an employer ismissing, or an employer is shown that you did not work for,or the earnings appear to be incorrect, call EDD and requesta correction. Please have this notice available if you call.

    EXPLANATION OF ITEMS ON THENOTICE OF UNEMPLOYMENT INSURANCE AWARD

    1. Claim Beginning Date: Your claim begins on the Sunday of theweek in which you filed your claim. It is not based on the dateyou became unemployed.

    2. Claim Ending Date: This is the date your claim year ends. Thisdate is 52 weeks from the claim beginning date. Benefitsremaining on this claim cannot be paid for weeks claimed afterthe claim ending date. A new claim must be filed if you are stillunemployed or partially unemployed after this date.

    3. Maximum Benefit Amount: The amount shown is yourmaximum UI award for this claim. The maximum award is26 times the weekly benefit amount or one-half of the total baseperiod wages, whichever is less (see page 4, Item 5, for anexplanation of the term base period). When you have receivedyour maximum award, no further benefits are payable. Youcannot file another California UI claim until your current claimyear ends.

    4. Weekly Benefit Amount: This is the amount of your weeklybenefit. It is the amount you will receive each week if you meetall eligibility requirements. If you work part-time and earn morethan $25 in a week, your weekly benefit amount will be reducedby your earnings that are over $25. In that case, the portion ofthe weekly benefit amount that you do not receive remains inyour claim for future use until your benefit year ends (see page16, Item 6, for more information).

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 3 of 35 CU

  • 5. Total Wages: This figure is the total amount of earningsreported by your employer(s) during the base period. Theseearnings were used to compute your maximum benefit amount.

    Your base period is a 12-month period of time.

    If Your Claim Your Base Period is the 12Begins in: Months Which Ended Last:

    January, February, March, September 30

    April, May, June, December 31

    July, August, September, March 31

    October, November, December June 30

    To establish a valid claim, you must have earned at least (1)$1300 in one quarter of your base period, or (2) at least $900in your highest quarter and a total of 1.25 times your highquarter earnings in the four quarters of your base period.

    A claim is invalid when there are not enough earnings toestablish a claim or when there was a prior claim and the workand earnings requirement to have a later claim have not beenmet (see page 12, Item 9).

    6. Highest Quarter Earnings: Your base period is divided intocalendar quarters. The quarter that you were paid the highestamount of wages determines your weekly benefit amount.

    EXAMPLE: Using the Notice of Unemployment InsuranceAward sample printed on page 2, the earnings foreach quarter are:

    Quarter Earnings

    January, February, March $2,122.34April, May, June $6,212.75July, August, September $1,974.55October, November, December $7,489.73

    In this example, the weekly benefit amount would be determinedby the October, November, December quarter because it hasthe highest earnings. By using the Benefit Table on the followingpage, you can see that if the high quarter earnings are$7,489.73, the weekly award is $289.

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 4 of 35 CU

  • $ 900.00 - 948.99 .. $ 40949.00 - 974.99 .... 41975.00 - 1,000.99 .... 42

    1,001.00 - 1,026.99 .... 431,027.00 - 1,052.99 .... 441,053.00 - 1,078.99 .... 451,079.00 - 1,117.99 .... 461,118.00 - 1,143.99 .... 471,144.00 - 1,169.99 .... 481,170.00 - 1,195.99 .... 491,196.00 - 1,221.99 .... 501,222.00 - 1,247.99 .... 511,248.00 - 1,286.99 .... 521,287.00 - 1,312.99 .... 531,313.00 - 1,338.99 .... 541,339.00 - 1,364.99 .... 551,365.00 - 1,403.99 .... 561,404.00 - 1,429.99 .... 571,430.00 - 1,455.99 .... 581,456.00 - 1,494.99 .... 591,495.00 - 1,520.99 .... 601,521.00 - 1,546.99 .... 611,547.00 - 1,585.99 .... 621,586.00 - 1,611.99 .... 631,612.00 - 1,637.99 .... 641,638.00 - 1,676.99 .... 651,677.00 - 1,702.99 .... 661,703.00 - 1,741.99 .... 671,742.00 - 1,767.99 .... 681,768.00 - 1,806.99 .... 691,807.00 - 1,832.99 .... 701,833.00 - 1,846.00 .... 711,846.01 - 1,872.00 .... 721,872.01 - 1,898.00 .... 731,898.01 - 1,924.00 .... 741,924.01 - 1,950.00 .... 751,950.01 - 1,976.00 .... 761,976.01 - 2,002.00 .... 772,002.01 - 2,028.00 .... 782,028.01 - 2,054.00 .... 792,054.01 - 2,080.00 .... 802,080.01 - 2,106.00 .... 81

    Unemployment Insurance Benefit TableFor New Claims With a Beginning Date of January 4, 2004, or After

    Amount of WeeklyWages in Benefit

    Highest Quarter Amount

    Amount of WeeklyWages in Benefit

    Highest Quarter Amount

    Amount of WeeklyWages in Benefit

    Highest Quarter Amount

    2,106.01 - 2,132.00 .... 822,132.01 - 2,158.00 .... 832,158.01 - 2,184.00 .... 842,184.01 - 2,210.00 .... 852,210.01 - 2,236.00 .... 862,236.01 - 2,262.00 .... 872,262.01 - 2,288.00 .... 882,288.01 - 2,314.00 .... 892,314.01 - 2,340.00 .... 902,340.01 - 2,366.00 .... 912,366.01 - 2,392.00 .... 922,392.01 - 2,418.00 .... 932,418.01 - 2,444.00 .... 942,444.01 - 2,470.00 .... 952,470.01 - 2,496.00 .... 962,496.01 - 2,522.00 .... 972,522.01 - 2,548.00 .... 982,548.01 - 2,574.00 .... 992,574.01 - 2,600.00 .... 1002,600.01 - 2,626.00 .... 1012,626.01 - 2,652.00 .... 1022,652.01 - 2,678.00 .... 1032,678.01 - 2,704.00 .... 1042,704.01 - 2,730.00 .... 1052,730.01 - 2,756.00 .... 1062,756.01 - 2,782.00 .... 1072,782.01 - 2,808.00 .... 1082,808.01 - 2,834.00 .... 1092,834.01 - 2,860.00 .... 1102,860.01 - 2,886.00 .... 1112,886.01 - 2,912.00 .... 1122,912.01 - 2,938.00 .... 1132,938.01 - 2,964.00 .... 1142,964.01 - 2,990.00 .... 1152,990.01 - 3,016.00 .... 1163,016.01 - 3,042.00 .... 1173,042.01 - 3,068.00 .... 1183,068.01 - 3,094.00 .... 1193,094.01 - 3,120.00 .... 1203,120.01 - 3,146.00 .... 1213,146.01 - 3,172.00 .... 1223,172.01 - 3,198.00 .... 123

    3,198.01 - 3,224.00 .... 1243,224.01 - 3,250.00 .... 1253,250.01 - 3,276.00 .... 1263,276.01 - 3,302.00 .... 1273,302.01 - 3,328.00 .... 1283,328.01 - 3,354.00 .... 1293,354.01 - 3,380.00 .... 1303,380.01 - 3,406.00 .... 1313,406.01 - 3,432.00 .... 1323,432.01 - 3,458.00 .... 1333,458.01 - 3,484.00 .... 1343,484.01 - 3,510.00 .... 1353,510.01 - 3,536.00 .... 1363,536.01 - 3,562.00 .... 1373,562.01 - 3,588.00 .... 1383,588.01 - 3,614.00 .... 1393,614.01 - 3,640.00 .... 1403,640.01 - 3,666.00 .... 1413,666.01 - 3,692.00 .... 1423,692.01 - 3,718.00 .... 1433,718.01 - 3,744.00 .... 1443,744.01 - 3,770.00 .... 1453,770.01 - 3,796.00 .... 1463,796.01 - 3,822.00 .... 1473,822.01 - 3,848.00 .... 1483,848.01 - 3,874.00 .... 1493,874.01 - 3,900.00 .... 1503,900.01 - 3,926.00 .... 1513,926.01 - 3,952.00 .... 1523,952.01 - 3,978.00 .... 1533,978.01 - 4,004.00 .... 1544,004.01 - 4,030.00 .... 1554,030.01 - 4,056.00 .... 1564,056.01 - 4,082.00 .... 1574,082.01 - 4,108.00 .... 1584,108.01 - 4,134.00 .... 1594,134.01 - 4,160.00 .... 1604,160.01 - 4,186.00 .... 1614,186.01 - 4,212.00 .... 1624,212.01 - 4,238.00 .... 1634,238.01 - 4,264.00 .... 1644,264.01 - 4,290.00 .... 165

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 5 of 35 CU

  • Unemployment Insurance Benefit TableFor New Claims With a Beginning Date of January 4, 2004, or After

    Amount of WeeklyWages in Benefit

    Highest Quarter Amount

    Amount of WeeklyWages in Benefit

    Highest Quarter Amount

    Amount of WeeklyWages in Benefit

    Highest Quarter Amount

    4,290.01 - 4,316.00 .... 1664,316.01 - 4,342.00 .... 1674,342.01 - 4,368.00 .... 1684,368.01 - 4,394.00 .... 1694,394.01 - 4,420.00 .... 1704,420.01 - 4,446.00 .... 1714,446.01 - 4,472.00 .... 1724,472.01 - 4,498.00 .... 1734,498.01 - 4,524.00 .... 1744,524.01 - 4,550.00 .... 1754,550.01 - 4,576.00 .... 1764,576.01 - 4,602.00 .... 1774,602.01 - 4,628.00 .... 1784,628.01 - 4,654.00 .... 1794,654.01 - 4,680.00 .... 1804,680.01 - 4,706.00 .... 1814,706.01 - 4,732.00 .... 1824,732.01 - 4,758.00 .... 1834,758.01 - 4,784.00 .... 1844,784.01 - 4,810.00 .... 1854,810.01 - 4,836.00 .... 1864,836.01 - 4,862.00 .... 1874,862.01 - 4,888.00 .... 1884,888.01 - 4,914.00 .... 1894,914.01 - 4,940.00 .... 1904,940.01 - 4,966.00 .... 1914,966.01 - 4,992.00 .... 1924,992.01 - 5,018.00 .... 1935,018.01 - 5,044.00 .... 1945,044.01 - 5,070.00 .... 1955,070.01 - 5,096.00 .... 1965,096.01 - 5,122.00 .... 1975,122.01 - 5,148.00 .... 1985,148.01 - 5,174.00 .... 1995,174.01 - 5,200.00 .... 2005,200.01 - 5,226.00 .... 2015,226.01 - 5,252.00 .... 2025,252.01 - 5,278.00 .... 2035,278.01 - 5,304.00 .... 2045,304.01 - 5,330.00 .... 2055,330.01 - 5,356.00 .... 2065,356.01 - 5,382.00 .... 207

    5,382.01 - 5,408.00 .... 2085,408.01 - 5,434.00 .... 2095,434.01 - 5,460.00 .... 2105,460.01 - 5,486.00 .... 2115,486.01 - 5,512.00 .... 2125,512.01 - 5,538.00 .... 2135,538.01 - 5,564.00 .... 2145,564.01 - 5,590.00 .... 2155,590.01 - 5,616.00 .... 2165,616.01 - 5,642.00 .... 2175,642.01 - 5,668.00 .... 2185,668.01 - 5,694.00 .... 2195,694.01 - 5,720.00 .... 2205,720.01 - 5,746.00 .... 2215,746.01 - 5,772.00 .... 2225,772.01 - 5,798.00 .... 2235,798.01 - 5,824.00 .... 2245,824.01 - 5,850.00 .... 2255,850.01 - 5,876.00 .... 2265,876.01 - 5,902.00 .... 2275,902.01 - 5,928.00 .... 2285,928.01 - 5,954.00 .... 2295,954.01 - 5,980.00 .... 2305,980.01 - 6,006.00 .... 2316,006.01 - 6,032.00 .... 2326,032.01 - 6,058.00 .... 2336,058.01 - 6,084.00 .... 2346,084.01 - 6,110.00 .... 2356,110.01 - 6,136.00 .... 2366,136.01 - 6,162.00 .... 2376,162.01 - 6,188.00 .... 2386,188.01 - 6,214.00 .... 2396,214.01 - 6,240.00 .... 2406,240.01 - 6,266.00 .... 2416,266.01 - 6,292.00 .... 2426,292.01 - 6,318.00 .... 2436,318.01 - 6,344.00 .... 2446,344.01 - 6,370.00 .... 2456,370.01 - 6,396.00 .... 2466,396.01 - 6,422.00 .... 2476,422.01 - 6,448.00 .... 2486,448.01 - 6,474.00 .... 249

    6,474.01 - 6,500.00 .... 2506,500.01 - 6,526.00 .... 2516,526.01 - 6,552.00 .... 2526,552.01 - 6,578.00 .... 2536,578.01 - 6,604.00 .... 2546,604.01 - 6,630.00 .... 2556,630.01 - 6,656.00 .... 2566,656.01 - 6,682.00 .... 2576,682.01 - 6,708.00 .... 2586,708.01 - 6,734.00 .... 2596,734.01 - 6,760.00 .... 2606,760.01 - 6,786.00 .... 2616,786.01 - 6,812.00 .... 2626,812.01 - 6,838.00 .... 2636,838.01 - 6,864.00 .... 2646,864.01 - 6,890.00 .... 2656,890.01 - 6,916.00 .... 2666,916.01 - 6,942.00 .... 2676,942.01 - 6,968.00 .... 2686,968.01 - 6,994.00 .... 2696,994.01 - 7,020.00 .... 2707,020.01 - 7,046.00 .... 2717,046.01 - 7,072.00 .... 2727,072.01 - 7,098.00 .... 2737,098.01 - 7,124.00 .... 2747,124.01 - 7,150.00 .... 2757,150.01 - 7,176.00 .... 2767,176.01 - 7,202.00 .... 2777,202.01 - 7,228.00 .... 2787,228.01 - 7,254.00 .... 2797,254.01 - 7,280.00 .... 2807,280.01 - 7,306.00 .... 2817,306.01 - 7,332.00 .... 2827,332.01 - 7,358.00 .... 2837,358.01 - 7,384.00 .... 2847,384.01 - 7,410.00 .... 2857,410.01 - 7,436.00 .... 2867,436.01 - 7,462.00 .... 2877,462.01 - 7,488.00 .... 2887,488.01 - 7,514.00 .... 2897,514.01 - 7,540.00 .... 2907,540.01 - 7,566.00 .... 291

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 6 of 35 CU

  • Unemployment Insurance Benefit TableFor New Claims With a Beginning Date of January 4, 2004, or After

    7,566.01 - 7,592.00 .... 2927,592.01 - 7,618.00 .... 2937,618.01 - 7,644.00 .... 2947,644.01 - 7,670.00 .... 2957,670.01 - 7,696.00 .... 2967,696.01 - 7,722.00 .... 2977,722.01 - 7,748.00 .... 2987,748.01 - 7,774.00 .... 2997,774.01 - 7,800.00 .... 3007,800.01 - 7,826.00 .... 3017,826.01 - 7,852.00 .... 3027,852.01 - 7,878.00 .... 3037,878.01 - 7,904.00 .... 3047,904.01 - 7,930.00 .... 3057,930.01 - 7,956.00 .... 3067,956.01 - 7,982.00 .... 3077,982.01 - 8,008.00 .... 3088,008.01 - 8,034.00 .... 3098,034.01 - 8,060.00 .... 3108,060.01 - 8,086.00 .... 3118,086.01 - 8,112.00 .... 3128,112.01 - 8,138.00 .... 3138,138.01 - 8,164.00 .... 3148,164.01 - 8,190.00 .... 3158,190.01 - 8,216.00 .... 3168,216.01 - 8,242.00 .... 3178,242.01 - 8,268.00 .... 3188,268.01 - 8,294.00 .... 3198,294.01 - 8,320.00 .... 3208,320.01 - 8,346.00 .... 3218,346.01 - 8,372.00 .... 3228,372.01 - 8,398.00 .... 3238,398.01 - 8,424.00 .... 3248,424.01 - 8,450.00 .... 3258,450.01 - 8,476.00 .... 3268,476.01 - 8,502.00 .... 3278,502.01 - 8,528.00 .... 3288,528.01 - 8,554.00 .... 3298,554.01 - 8,580.00 .... 3308,580.01 - 8,606.00 .... 331

    8,606.01 - 8,632.00 .... 3328,632.01 - 8,658.00 .... 3338,658.01 - 8,684.00 .... 3348,684.01 - 8,710.00 .... 3358,710.01 - 8,736.00 .... 3368,736.01 - 8,762.00 .... 3378,762.01 - 8,788.00 .... 3388,788.01 - 8,814.00 .... 3398,814.01 - 8,840.00 .... 3408,840.01 - 8,866.00 .... 3418,866.01 - 8,892.00 .... 3428,892.01 - 8,918.00 .... 3438,918.01 - 8,944.00 .... 3448,944.01 - 8,970.00 .... 3458,970.01 - 8,996.00 .... 3468,996.01 - 9,022.00 .... 3479,022.01 - 9,048.00 .... 3489,048.01 - 9,074.00 .... 3499,074.01 - 9,100.00 .... 3509,100.01 - 9,126.00 .... 3519,126.01 - 9,152.00 .... 3529,152.01 - 9,178.00 .... 3539,178.01 - 9,204.00 .... 3549,204.01 - 9,230.00 .... 3559,230.01 - 9,256.00 .... 3569,256.01 - 9,282.00 .... 3579,282.01 - 9,308.00 .... 3589,308.01 - 9,334.00 .... 3599,334.01 - 9,360.00 .... 3609,360.01 - 9,386.00 .... 3619,386.01 - 9,412.00 .... 3629,412.01 - 9,438.00 .... 3639,438.01 - 9,464.00 .... 3649,464.01 - 9,490.00 .... 3659,490.01 - 9,516.00 .... 3669,516.01 - 9,542.00 .... 3679,542.01 - 9,568.00 .... 3689,568.01 - 9,594.00 .... 3699,594.01 - 9,620.00 .... 3709,620.01 - 9,646.00 .... 371

    Amount of WeeklyWages in Benefit

    Highest Quarter Amount

    Amount of WeeklyWages in Benefit

    Highest Quarter Amount

    Amount of WeeklyWages in Benefit

    Highest Quarter Amount

    9,646.01 - 9,672.00 .... 3729,672.01 - 9,698.00 .... 3739,698.01 - 9,724.00 .... 3749,724.01 - 9,750.00 .... 3759,750.01 - 9,776.00 .... 3769,776.01 - 9,802.00 .... 3779,802.01 - 9,828.00 .... 3789,828.01 - 9,854.00 .... 3799,854.01 - 9,880.00 .... 3809,880.01 - 9,906.00 .... 3819,906.01 - 9,932.00 .... 3829,932.01 - 9,958.00 .... 3839,958.01 - 9,984.00 .... 3849,984.01 -10,010.00 .... 385

    10,010.01 -10,036.00 .... 38610,036.01 -10,062.00 .... 38710,062.01 -10,088.00 .... 38810,088.01 -10,114.00 .... 38910,114.01 -10,140.00 .... 39010,140.01 -10,166.00 .... 39110,166.01 -10,192.00 .... 39210,192.01 -10,218.00 .... 39310,218.01 -10,244.00 .... 39410,244.01 -10,270.00 .... 39510,270.01 -10,296.00 .... 39610,296.01 -10,322.00 .... 39710,322.01 -10,348.00 .... 39810,348.01 -10,374.00 .... 39910,374.01 -10,400.00 .... 40010,400.01 -10,426.00 .... 40110,426.01 -10,452.00 .... 40210,452.01 -10,478.00 .... 40310,478.01 -10,504.00 .... 40410,504.01 -10,530.00 .... 40510,530.01 -10,556.00 .... 40610,556.01 -10,582.00 .... 40710,582.01 -10,608.00 .... 40810,608.01 -10,634.00 .... 40910,634.01 - and over .... 410

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 7 of 35 CU

  • $ 900.00 948.99 $ 40949.00 974.99 41975.00 1,000.99 42

    1,001.00 1,026.99 431,027.00 1,052.99 441,053.00 1,078.99 451,079.00 1,117.99 461,118.00 1,143.99 471,144.00 1,169.99 481,170.00 1,195.99 491,196.00 1,221.99 501,222.00 1,247.99 511,248.00 1,286.99 521,287.00 1,312.99 531,313.00 1,338.99 541,339.00 1,364.99 551,365.00 1,403.99 561,404.00 1,429.99 571,430.00 1,455.99 581,456.00 1,494.99 591,495.00 1,520.99 601,521.00 1,546.99 611,547.00 1,585.99 621,586.00 1,611.99 631,612.00 1,637.99 641,638.00 1,676.99 651,677.00 1,702.99 661,703.00 1,741.99 671,742.00 1,767.99 681,768.00 1,806.99 691,807.00 1,832.99 701,833.00 1,846.00 711,846.01 1,872.00 721,872.01 1,898.00 731,898.01 1,924.00 741,924.01 1,950.00 751,950.01 1,976.00 761,976.01 2,002.00 772,002.01 2,028.00 782,028.01 2,054.00 792,054.01 2,080.00 802,080.01 2,106.00 812,106.01 2,132.00 822,132.01 2,158.00 832,158.01 2,184.00 842,184.01 2,210.00 85

    Unemployment Insurance Benefit TableFor New Claims With a Beginning Date of January 2, 2005 or After

    Amount of WeeklyWages in Benefit

    Highest Quarter Amount

    Amount of WeeklyWages in Benefit

    Highest Quarter Amount

    Amount of WeeklyWages in Benefit

    Highest Quarter Amount

    2,210.01 2,236.00 862,236.01 2,262.00 872,262.01 2,288.00 882,288.01 2,314.00 892,314.01 2,340.00 902,340.01 2,366.00 912,366.01 2,392.00 922,392.01 2,418.00 932,418.01 2,444.00 942,444.01 2,470.00 952,470.01 2,496.00 962,496.01 2,522.00 972,522.01 2,548.00 982,548.01 2,574.00 992,574.01 2,600.00 1002,600.01 2,626.00 1012,626.01 2,652.00 1022,652.01 2,678.00 1032,678.01 2,704.00 1042,704.01 2,730.00 1052,730.01 2,756.00 1062,756.01 2,782.00 1072,782.01 2,808.00 1082,808.01 2,834.00 1092,834.01 2,860.00 1102,860.01 2,886.00 1112,886.01 2,912.00 1122,912.01 2,938.00 1132,938.01 2,964.00 1142,964.01 2,990.00 1152,990.01 3,016.00 1163,016.01 3,042.00 1173,042.01 3,068.00 1183,068.01 3,094.00 1193,094.01 3,120.00 1203,120.01 3,146.00 1213,146.01 3,172.00 1223,172.01 3,198.00 1233,198.01 3,224.00 1243,224.01 3,250.00 1253,250.01 3,276.00 1263,276.01 3,302.00 1273,302.01 3,328.00 1283,328.01 3,354.00 1293,354.01 3,380.00 1303,380.01 3,406.00 131

    3,406.01 3,432.00 1323,432.01 3,458.00 1333,458.01 3,484.00 1343,484.01 3,510.00 1353,510.01 3,536.00 1363,536.01 3,562.00 1373,562.01 3,588.00 1383,588.01 3,614.00 1393,614.01 3,640.00 1403,640.01 3,666.00 1413,666.01 3,692.00 1423,692.01 3,718.00 1433,718.01 3,744.00 1443,744.01 3,770.00 1453,770.01 3,796.00 1463,796.01 3,822.00 1473,822.01 3,848.00 1483,848.01 3,874.00 1493,874.01 3,900.00 1503,900.01 3,926.00 1513,926.01 3,952.00 1523,952.01 3,978.00 1533,978.01 4,004.00 1544,004.01 4,030.00 1554,030.01 4,056.00 1564,056.01 4,082.00 1574,082.01 4,108.00 1584,108.01 4,134.00 1594,134.01 4,160.00 1604,160.01 4,186.00 1614,186.01 4,212.00 1624,212.01 4,238.00 1634,238.01 4,264.00 1644,264.01 4,290.00 1654,290.01 4,316.00 1664,316.01 4,342.00 1674,342.01 4,368.00 1684,368.01 4,394.00 1694,394.01 4,420.00 1704,420.01 4,446.00 1714,446.01 4,472.00 1724,472.01 4,498.00 1734,498.01 4,524.00 1744,524.01 4,550.00 1754,550.01 4,576.00 1764,576.01 4,602.00 177

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 8 of 35 CU

  • Unemployment Insurance Benefit TableFor New Claims With a Beginning Date of January 2, 2005 or After

    Amount of WeeklyWages in Benefit

    Highest Quarter Amount

    Amount of WeeklyWages in Benefit

    Highest Quarter Amount

    Amount of WeeklyWages in Benefit

    Highest Quarter Amount

    4,602.01 4,628.00 1784,628.01 4,654.00 1794,654.01 4,680.00 1804,680.01 4,706.00 1814,706.01 4,732.00 1824,732.01 4,758.00 1834,758.01 4,784.00 1844,784.01 4,810.00 1854,810.01 4,836.00 1864,836.01 4,862.00 1874,862.01 4,888.00 1884,888.01 4,914.00 1894,914.01 4,940.00 1904,940.01 4,966.00 1914,966.01 4,992.00 1924,992.01 5,018.00 1935,018.01 5,044.00 1945,044.01 5,070.00 1955,070.01 5,096.00 1965,096.01 5,122.00 1975,122.01 5,148.00 1985,148.01 5,174.00 1995,174.01 5,200.00 2005,200.01 5,226.00 2015,226.01 5,252.00 2025,252.01 5,278.00 2035,278.01 5,304.00 2045,304.01 5,330.00 2055,330.01 5,356.00 2065,356.01 5,382.00 2075,382.01 5,408.00 2085,408.01 5,434.00 2095,434.01 5,460.00 2105,460.01 5,486.00 2115,486.01 5,512.00 2125,512.01 5,538.00 2135,538.01 5,564.00 2145,564.01 5,590.00 2155,590.01 5,616.00 2165,616.01 5,642.00 2175,642.01 5,668.00 2185,668.01 5,694.00 2195,694.01 5,720.00 2205,720.01 5,746.00 2215,746.01 5,772.00 2225,772.01 5,798.00 223

    5,798.01 5,824.00 2245,824.01 5,850.00 2255,850.01 5,876.00 2265,876.01 5,902.00 2275,902.01 5,928.00 2285,928.01 5,954.00 2295,954.01 5,980.00 2305,980.01 6,006.00 2316,006.01 6,032.00 2326,032.01 6,058.00 2336,058.01 6,084.00 2346,084.01 6,110.00 2356,110.01 6,136.00 2366,136.01 6,162.00 2376,162.01 6,188.00 2386,188.01 6,214.00 2396,214.01 6,240.00 2406,240.01 6,266.00 2416,266.01 6,292.00 2426,292.01 6,318.00 2436,318.01 6,344.00 2446,344.01 6,370.00 2456,370.01 6,396.00 2466,396.01 6,422.00 2476,422.01 6,448.00 2486,448.01 6,474.00 2496,474.01 6,500.00 2506,500.01 6,526.00 2516,526.01 6,552.00 2526,552.01 6,578.00 2536,578.01 6,604.00 2546,604.01 6,630.00 2556,630.01 6,656.00 2566,656.01 6,682.00 2576,682.01 6,708.00 2586,708.01 6,734.00 2596,734.01 6,760.00 2606,760.01 6,786.00 2616,786.01 6,812.00 2626,812.01 6,838.00 2636,838.01 6,864.00 2646,864.01 6,890.00 2656,890.01 6,916.00 2666,916.01 6,942.00 2676,942.01 6,968.00 2686,968.01 6,994.00 269

    6,994.01 7,020.00 2707,020.01 7,046.00 2717,046.01 7,072.00 2727,072.01 7,098.00 2737,098.01 7,124.00 2747,124.01 7,150.00 2757,150.01 7,176.00 2767,176.01 7,202.00 2777,202.01 7,228.00 2787,228.01 7,254.00 2797,254.01 7,280.00 2807,280.01 7,306.00 2817,306.01 7,332.00 2827,332.01 7,358.00 2837,358.01 7,384.00 2847,384.01 7,410.00 2857,410.01 7,436.00 2867,436.01 7,462.00 2877,462.01 7,488.00 2887,488.01 7,514.00 2897,514.01 7,540.00 2907,540.01 7,566.00 2917,566.01 7,592.00 2927,592.01 7,618.00 2937,618.01 7,644.00 2947,644.01 7,670.00 2957,670.01 7,696.00 2967,696.01 7,722.00 2977,722.01 7,748.00 2987,748.01 7,774.00 2997,774.01 7,800.00 3007,800.01 7,826.00 3017,826.01 7,852.00 3027,852.01 7,878.00 3037,878.01 7,904.00 3047,904.01 7,930.00 3057,930.01 7,956.00 3067,956.01 7,982.00 3077,982.01 8,008.00 3088,008.01 8,034.00 3098,034.01 8,060.00 3108,060.01 8,086.00 3118,086.01 8,112.00 3128,112.01 8,138.00 3138,138.01 8,164.00 3148,164.01 8,190.00 315

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 9 of 35 CU

  • Unemployment Insurance Benefit TableFor New Claims With a Beginning Date of January 2, 2005 or After

    Amount of WeeklyWages in Benefit

    Highest Quarter Amount

    Amount of WeeklyWages in Benefit

    Highest Quarter Amount

    Amount of WeeklyWages in Benefit

    Highest Quarter Amount

    10,582.01 10,608.00 40810,608.01 10,634.00 40910,634.01 10,660.00 41010,660.01 10,686.00 41110,686.01 10,712.00 41210,712.01 10,738.00 41310,738.01 10,764.00 41410,764.01 10,790.00 41510,790.01 10,816.00 41610,816.01 10,842.00 41710,842.01 10,868.00 41810,868.01 10,894.00 41910,894.01 10,920.00 42010,920.01 10,946.00 42110,946.01 10,972.00 42210,972.01 10,998.00 42310,998.01 11,024.00 42411,024.01 11,050.00 42511,050.01 11,076.00 42611,076.01 11,102.00 42711,102.01 11,128.00 42811,128.01 11,154.00 42911,154.01 11,180.00 43011,180.01 11,206.00 43111,206.01 11,232.00 43211,232.01 11,258.00 43311,258.01 11,284.00 43411,284.01 11,310.00 43511,310.01 11,336.00 43611,336.01 11,362.00 43711,362.01 11,388.00 43811,388.01 11,414.00 43911,414.01 11,440.00 44011,440.01 11,466.00 44111,466.01 11,492.00 44211,492.01 11,518.00 44311,518.01 11,544.00 44411,544.01 11,570.00 44511,570.01 11,596.00 44611,596.01 11,622.00 44711,622.01 11,648.00 44811,648.01 11,674.00 44911,674.01 and over 450

    8,190.01 8,216.00 3168,216.01 8,242.00 3178,242.01 8,268.00 3188,268.01 8,294.00 3198,294.01 8,320.00 3208,320.01 8,346.00 3218,346.01 8,372.00 3228,372.01 8,398.00 3238,398.01 8,424.00 3248,424.01 8,450.00 3258,450.01 8,476.00 3268,476.01 8,502.00 3278,502.01 8,528.00 3288,528.01 8,554.00 3298,554.01 8,580.00 3308,580.01 8,606.00 3318,606.01 8,632.00 3328,632.01 8,658.00 3338,658.01 8,684.00 3348,684.01 8,710.00 3358,710.01 8,736.00 3368,736.01 8,762.00 3378,762.01 8,788.00 3388,788.01 8,814.00 3398,814.01 8,840.00 3408,840.01 8,866.00 3418,866.01 8,892.00 3428,892.01 8,918.00 3438,918.01 8,944.00 3448,944.01 8,970.00 3458,970.01 8,996.00 3468,996.01 9,022.00 3479,022.01 9,048.00 3489,048.01 9,074.00 3499,074.01 9,100.00 3509,100.01 9,126.00 3519,126.01 9,152.00 3529,152.01 9,178.00 3539,178.01 9,204.00 3549,204.01 9,230.00 3559,230.01 9,256.00 3569,256.01 9,282.00 3579,282.01 9,308.00 3589,308.01 9,334.00 3599,334.01 9,360.00 3609,360.01 9,386.00 361

    9,386.01 9,412.00 3629,412.01 9,438.00 3639,438.01 9,464.00 3649,464.01 9,490.00 3659,490.01 9,516.00 3669,516.01 9,542.00 3679,542.01 9,568.00 3689,568.01 9,594.00 3699,594.01 9,620.00 3709,620.01 9,646.00 3719,646.01 9,672.00 3729,672.01 9,698.00 3739,698.01 9,724.00 3749,724.01 9,750.00 3759,750.01 9,776.00 3769,776.01 9,802.00 3779,802.01 9,828.00 3789,828.01 9,854.00 3799,854.01 9,880.00 3809,880.01 9,906.00 3819,906.01 9,932.00 3829,932.01 9,958.00 3839,958.01 9,984.00 384

    9,984.01 10,010.00 38510,010.01 10,036.00 38610,036.01 10,062.00 38710,062.01 10,088.00 38810,088.01 10,114.00 38910,114.01 10,140.00 39010,140.01 10,166.00 39110,166.01 10,192.00 39210,192.01 10,218.00 39310,218.01 10,244.00 39410,244.01 10,270.00 39510,270.01 10,296.00 39610,296.01 10,322.00 39710,322.01 10,348.00 39810,348.01 10,374.00 39910,374.01 10,400.00 40010,400.01 10,426.00 40110,426.01 10,452.00 40210,452.01 10,478.00 40310,478.01 10,504.00 40410,504.01 10,530.00 40510,530.01 10,556.00 40610,556.01 10,582.00 407

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 10 of 35 CU

  • Items 7, 8, and 9 contain additional requirements which affectsome claims. If the statement "this item does not apply toyour claim" appears, that requirement or condition does notaffect your claim.

    7. School Employee wages: You may not be able to receivebenefits that are based on school wages during a school recessperiod. School wages include work for an educational institutionor with a nonprofit organization or any public entity employerthat provided services to or on behalf of an educationalinstitution. The maximum and weekly benefits awards shownhere are the awards without the school wages. These awardsare the amounts that may be payable if your claim is filed duringa school recess period. If you did not have any or you did nothave enough non-educational earnings, it will state This itemdoes not apply to your claim.

    8. Work Search Requirements: To be eligible for UI benefits, youmust conduct a reasonable effort to search for suitable work.Below are some tips for looking for work.

    The kind of work you are looking for, whether full-time or part-time, will determine how you look for work. Some jobs require arsum while other jobs require an in-person visit and anapplication. Tips for looking for work include:

    Register with EDD Job Service. Respond to want ads in the newspaper. Contact employers who may have jobs in your field. Contact prior employers. Tell friends and relatives that you are looking for

    work. Check trade books for your occupation. Send rsums. Register with placement facilities of a school, college,

    university, or professional organization.

    Your individual instructions for conducting a work search areshown here. Your instructions will be one of the following:

    You must look for full-time work each week.

    This means you are required to look for full-time workeach week to remain eligible for UI benefits.

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 11 of 35 CU

  • You must look for part-time work each week asinstructed by EDD.

    This means you are required to look for part-time workeach week as instructed by EDD to remain eligible for UIbenefits. You must also be able to work and available forpart-time work each week as instructed by EDD.

    You must register with your union and look for full-timework each week.

    This means that you are required to follow your unionsrequirements for registering as out of work and you mustalso look for full-time work on your own to remain eligiblefor UI benefits.

    You must register with your union and look for part-timework each week as instructed by EDD.

    This means that you are required to follow your unionsrequirements for registering as out of work and you mustalso look for part-time work on your own as instructed byEDD to remain eligible for UI benefits.

    You must register with your union and meet all unionreporting requirements and dispatch contacts.

    Since your union controls hiring in your occupation, youmust meet all union requirements for dispatch. If you arenot in good standing with your union, you may not beeligible for UI benefits.

    You must be able to work and available for work eachweek.

    This means that you are not required to look for work, butyou must be able to work and available for work eachweek to be eligible for UI benefits.

    This item does not apply to your claim.

    You are claiming benefits under a special program thatdoes not require a search for work, such as Work Share.

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 12 of 35 CU

  • IF YOU HAVE ANY QUESTIONS ABOUTYOUR NOTICE OF UNEMPLOYMENTINSURANCE AWARD, CALLIMMEDIATELY.

    9. Requalification Requirements: To requalify for a secondclaim you must have worked and earned at least (1) $1300 inone quarter, or (2) at least $900 in your highest quarter and atotal of 1.25 times your high quarter earnings during the benefityear of your original claim. (In some cases, Workers'Compensation or Disability Insurance benefits may be used inplace of earnings.)

    10. Employees Name(s): This is the name your employer used toreport your earnings to EDD. Do not be concerned about minormisspellings in your name as long as the earnings shown areyours.

    11. Employee's Wages for the Calendar Quarter Ending: Theseare the four quarters in your base period and the wages youremployer(s) reported you earned in each of the quarters.These earnings determine the amount of your UI award. If youtold EDD that you worked for a federal agency or in anotherstate when you filed your claim, your wages are beingrequested from that agency or state. You will receive anamended notice when the federal wages or other state's wageshave been added.If you worked in more than one state, you may be able tocombine the wages you earned during your base period into acombined wage claim. Combining these wages could increaseyour maximum and/or your weekly benefit amount. If you didnot tell EDD at the time you filed your claim that you worked inmore than one state, call EDD immediately.

    If you believe the earnings shown areincorrect or are not your wages, call

    EDD and request a correction.12. Employer Name: This is the name(s) of the employer(s) who

    reported the quarterly wages shown in Item 11. If you did notwork for an employer shown, or if you worked for anemployer(s) that is not shown, call EDD and request acorrection.

    13. Totals: This is the total amount of earnings reported by youremployer(s) in each calendar quarter listed in Item 11.

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 13 of 35 CU

  • WAITING PERIOD

    California law requires every person to serve a one week UNPAIDwaiting period. There is only one waiting period during each52 week claim year. The waiting week is usually the first otherwisepayable week in your benefit year (otherwise payable means youwould have been eligible for payment in every way but for thewaiting period requirement).There are two exceptions when a week other than the firstotherwise payable week is used as the waiting period:

    1. If you received benefits the last week of the benefit year of yourclaim and you filed a second claim starting the following week,the waiting period for the second claim will be taken after thefirst break in payment status on the new claim.

    2. You may receive waiting period credit for your new claim on thelast week of your prior claim if:

    All benefits were previously paid on your old claim, and

    You file a new claim within the last week of the old claim,and

    You are otherwise eligible for benefits for the last week of theold claim.

    CANCELLING A CLAIM

    If you find that you would benefit by waiting until a later date to fileyour claim, you may be able to cancel this claim. You can cancelyour claim up to and including 30 days after the mailing of theNotice of Unemployment Insurance Award if you have not cashed abenefit check or have not been issued a written notice ofdisqualification. If you have questions regarding claim cancellationor want to cancel your claim, call EDD.

    IMPORTANT: Once a claim has been cancelled,it cannot be reestablished withthe same beginning date.

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 14 of 35 CU

  • CLAIMING UNEMPLOYMENT INSURANCE BENEFITS

    Your notice of UI award was mailed with this booklet. Your firstContinued Claim form is mailed separately. If you do not receive theclaim form within 10 days of filing your claim, call EDD and request aduplicate. You cannot be paid UI benefits unless you submit acompleted and signed Continued Claim form.

    Complete and mail the Continued Claim form on the dateshown on the front of the form. Mailing the claim form morethan 14 days after the last week ending date on the form couldcause you to lose your benefits.

    An explanation of the questions on the form is provided on the following pages.

    The EDD uses an Optical Character Recognition (OCR) machine inits payment system. The OCR machine reads numbers, scans themarks on your claim form, and issues your UI check. The OCRmachine only reads clearly printed numbers. An example of how tofill in the blocks and write your numbers is on the back of everyclaim form. If the OCR machine cannot read your form, anotherContinued Claim form for the same week(s) will be mailed to you tocomplete. Do not staple the Continued Claim form or include anyother mail in the claim form envelope.

    Continued Claim Form Sample

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 15 of 35 CU

  • EXPLANATION OF QUESTIONS ON THE CLAIM FORM

    1. Were you too sick or injured to work? - You must be wellenough to work every day of the week to receive full benefits. Ifyou are unable to work because of illness or injury, you mustreport the number of days that you could not work.Unemployment benefits are paid according to the number ofdays you are able to work. Your benefits are reduced one-seventh for each day that you cannot work.

    2. Was there any reason (other than sickness or injury) thatyou could not have accepted full-time work each workday?- You must be available for work to receive unemploymentbenefits. Available means you are ready and willing to acceptwork that matches your occupational skills and educationalbackground. Examples of reasons a person cannot work includelack of child care, lack of transportation, personal business, orbeing on vacation.

    3. Did you look for work? - You must follow the work searchrequirements on your Notice of Unemployment Insurance Award.Work searches may include in-person, mail, telephone, or Internetcontacts with employers. Failure to follow the instructions mayresult in loss of benefits for the week. Union members shouldanswer yes to this question if you meet your unions reportingand dispatch requirements.

    If the block under Question #3 is marked with an X, list your jobcontacts in Section B on the back of the form.

    4. Did you refuse any work? - Answer yes if you refused anoffer of work from any employer. Union members answer yes ifyou refused a union referral to a job. If you refused work, youwill be scheduled for an interview to determine your continuedeligibility for benefits.

    5. Did you begin attending any kind of school or training? -Answer yes only if you began attending school or training inthat week. Afterwards answer yes only when a new termbegins or you start new classes during one of the weeks. Sinceattendance in school or training may affect your eligibility forbenefits, an interview will be scheduled to determine yourcontinued eligibility.

    If you do not provide an answer toQuestions #1 through #6, and leave any ofthose blocks blank, another claim form will

    be mailed to you for completion.This will delay benefit payment.

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 16 of 35 CU

  • 6. Did you work or earn any money, WHETHER YOU WEREPAID OR NOT? - Answer yes if you performed any workduring a week. All work and/or earnings must be reported,including:

    If you answered yes, enter your earnings before taxes in Itema. NOTE: Item a. only allows for an entry of up to $999.99. Ifyour earnings are $1,000.00 or more in a week enter $999.99.Enter the last day worked and source of earnings in Item b. Ifyou are still working, write "still working full time" or "still workingpart time." NOTE: Item b. Look at the date each week beginsand ends. Be careful that your answers in 6b apply only to theweeks shown on the form.

    You may be able to work part time and receive reduced UIbenefits, even if your earnings are higher than your weeklybenefit amount. You report your total earnings beforedeductions and EDD will figure the amount to deduct.

    If your weekly earnings are $100 or less, EDD does notcount the first $25. The amount of earnings over $25 issubtracted from your weekly benefit amount and you arepaid the difference, if any.

    If your weekly earnings are $101 or more, EDD does notcount the first 25 percent of your earnings. The amount ofearnings remaining is subtracted from your weekly benefitamount and you are paid the difference, if any.

    If you receive Temporary Total Disability, VocationalRehabilitation Maintenance Allowance, or deductible pensionpayments, EDD deducts the amount, dollar-for-dollar, from yourweekly benefit amount.

    NOTE: The EDD has a fraud detection system. If you do notreport all earnings for a week that you worked, and youreceive benefits, you will be investigated. If EDDdetermines that you were at fault for not reporting yourearnings, you could face administrative and/or criminalpenalties.

    Back pay award Jury fees Self-employmentBonuses Paid sick leave Severance payCommissions Pensions Strike benefitsHoliday pay Piece work TipsIdle time pay Residual pay (ask for Vacation payIn lieu of notice form DE 4005) Witness feesYou must report lodging and meals, or any other paymentyou receive instead of money when you work. If you areunsure about how to report wages, call EDD.

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  • 7. If you want federal income tax withheld for the week(s)shown above, mark this block. - If you want Federal IncomeTax withheld for the weeks shown on your claim form, fill in theanswer block on that claim form. If you do not want taxeswithheld, leave the answer block blank. Your choice remains ineffect only until you send in your next Continued Claim form.

    For more information about voluntary Federal Income Tax withholding see page 34.

    8. If you had a change of mailing address or phone number,mark this block and complete Sec. D on reverse. - You mustreport a change of mailing address to avoid delay in receivingyour benefit checks. To report a change of mailing address ortelephone number, mark the block and print your new address(including ZIP code) or telephone number (including area code)in Section D on the back of the Continued Claim form.

    If you move to another state and still want to claimbenefits, call 1-800-250-3913 for instructions. Failure tocontact the office promptly could result in a delay or lossof your benefits.

    The lower portion of your Continued Claim form contains thefollowing statement:

    I understand the questions on this form. I know the lawprovides penalties if I make false statements or withholdfacts to receive benefits; my answers are true and correct. Ideclare under penalty of perjury that I am a U.S. citizen ornational; or an alien in satisfactory immigration status andpermitted to work by USCIS. I signed this form after thelatest date for which I am claiming benefits.

    You must sign your Continued Claim form and answer all ofthe questions in order to receive payment. If you are notsure how to answer the questions or are not legally entitledto work in this country, call EDD immediately.You are responsible for the answers on your Continued Claim form.

    If you give false information or do not report information that you should report, you may be subject to disqualification and penalties.

    If you do not want to claim benefits for the week(s) on theclaim form, do not complete or mail the form to EDD.

    If you want to reopen your claim afteryou have stopped claiming benefits, callEDD or file on-line using eApply4UI at

    www.edd.ca.gov/eapply4ui.

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 18 of 35 CU

  • Section A - Provides examples of how to complete the claim form.As you can see in EXAMPLE (a), there are only threeboxes for the dollar amount earned. If your earningsare $1,000.00 or more in a week, enter $999.99 inItem 6. a. on the front of the form.

    Section B - If the box in Question 3 is checked on the front of theform, record your job contacts for the week(s) shown.

    Section C - After you have been approved by EDD for trainingbenefits, your training facility must complete thissection for each week you attend training.

    If you are on a semester/holiday recess, enter thedate you are scheduled to return to school on the lineprovided.

    Section D - Used to provide a change of address or telephonenumber (be sure to mark the block in Item 8 on thefront of the form).AVOID PAYMENT DELAYS, MAKE SURE:

    Completing the Back of the Continued Claim Form

    You signed the form. You answered all questions. Nothing is attached to the form.

    The form is mailedimmediately after the lastweek-ending date on theform has passed.

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  • UNEMPLOYMENT INSURANCE CHECKS

    The EDD mails your UI checks to you from a central location. Thecheck, your new claim form, and a message stub are printed on athree-part form:

    We issue an envelope with your claim form. Mail yourclaim form, folding it back along the pre-folded line sothat the address printed in the lower left hand corner ofthe Continued Claim form shows through the window ofthe envelope. Do not mail or take your Continued Claimform to any other address unless instructed to do so.

    If you do not receive your check or a response from EDD within10 days of mailing your claim form, or if you have received yourcheck and it has been lost, stolen, or destroyed, call EDDimmediately.

    The stub portion at the top of the form contains informationabout your claim and important messages. You must read,detach, and save the stub for your record.

    The middle section of the form is your Continued Claim form.Use it to claim benefits for the next week(s).Note: If this section is blank, disregard the preprinted

    reverse side of the form and do not mail the formback to EDD.

    The bottom portion contains your check. Detach and cashthe check where you normally cash checks.

    UI CHECKS ARE VALID FOR ONE YEAR FROM DATEOF ISSUE.

    If a check is not issued, only your address and the EDDoffice address will appear in this space. Detach and destroythis portion of the form. It should not be mailed back to EDDwith your completed form.

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  • UNEMPLOYMENT INSURANCE ELIGIBILITY REQUIREMENTS

    In order to receive UI benefits you must meet certain eligibilityrequirements. There is a question regarding your eligibility if you:

    Quit your job. Were fired from your job. Are out of work due to a strike or lockout. Do not have child care. Do not have transportation. Do not look for work as instructed. File your claim late. Mail your claim form late. Refuse a job. Give incorrect information or withhold information. Fail to participate in re-employment activities. Are a school employee filing a claim during a recess period. Are a professional athlete filing a claim during the off-season. Are/were not in satisfactory immigration status or legally

    authorized to work. Are attending school during normal working hours for your

    occupation. Are not physically or mentally able to work during normal

    working hours for your occupation.

    If you are scheduled for an interview because there is a question ofyour eligibility, EDD will call you at the scheduled interview date andtime. You have the right to request more time if you need to contactwitnesses, gather information, or obtain the advice of a representative.To request more time, call EDD.

    The interviewer will ask you questions about the eligibility issue. Werecord your information and use it to make a decision. If theinterview involves an employer, we may contact the employer foradditional information. The EDD makes a decision based on all theinformation available. If you are denied benefits, a written Notice ofDetermination will be mailed to you. The notice advises you of thereason for EDDs decision and gives you information about yourappeal rights.

    If you are not available for a scheduled eligibilityinterview and do not call EDD to arrange anotherappointment, a decision can be made based onthe available facts that may result in denial of yourbenefits.

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  • PENALTIES

    If you willfully give false information or withhold information to claimbenefits, EDD will assess a false statement disqualification. A falsestatement disqualification is a penalty that denies you benefits from2 to 23 weeks. To end the disqualification, you must first meet allthe usual eligibility requirements, then serve the penalty by mailingin Continued Claim forms for the number of weeks disqualified. Thepenalty stays on your record for three years or until served,whichever comes first.

    It is illegal to willfully make false statements or knowingly fail toreport all facts to receive benefits. Making a false statement orwithholding information to receive benefits can be a felony. Aperson convicted under Section 2101 of the UnemploymentInsurance Code will lose the right to collect benefits for 52 weeks.Penalties may include both fines and criminal prosecution.

    NOTE: Serving the false statement disqualification doesnot repay nor reduce the amount of anyoverpayment.

    OVERPAYMENTS

    A Notice of Overpayment is mailed to you when you have been paidUI benefits that you were not eligible to receive. The Notice showsthe amount of the overpayment and penalties, if any. It explainswhy you were overpaid and gives you information about yourappeal rights.

    The EDD classifies overpayments into two categories, non-fraud orfraud:

    Non-Fraud: When you have received benefits to which you werenot entitled and you are not at fault, the overpayment is considerednon-fraud. In some cases, you may not have to repay a non-fraudoverpayment. You will receive a notice telling you if theoverpayment must be repaid.

    Fraud: A fraud overpayment occurs when you knowingly give falseinformation or withhold information and receive benefits that youshould not have received. Withholding or giving false information toobtain unemployment insurance benefits are serious offenses thatcan result in criminal prosecution. With a fraud overpayment, youare assessed a penalty in the amount of 30 percent of the amountof the overpayment and a false statement disqualification of 5 to 23weeks. Fraud overpayments and penalties must be repaid.

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  • If you do not repay your overpayment promptly, EDD will deduct themoney owed from your future weekly unemployment or statedisability insurance benefits. This process is referred to as an offset.The EDD may offset up to 100 percent of your benefits. Since EDDcannot offset the penalty portion of an overpayment from yourbenefits, you must submit a payment to repay the penalty. The EDDmay reduce or totally withhold your state income tax refunds, lotterywinnings, or any other money owed to you by the state, to repayyour overpayment. The EDD may also file a claim against you incourt, charge you court costs and interest, and record a lien on yourproperty. You can use your credit card to pay your benefitoverpayment.NOTE: Repaying an overpayment does not remove a

    disqualification. Call EDD for more information.APPEALING AN EDD NOTICE

    You may appeal any written EDD decision. You must file your appealin writing and you must state the reasons why you disagree with thedecision. You may file an appeal by mail by sending a letter to theaddress on your Notice of Determination. A letter of appeal mustinclude your name, Social Security number, and the reasons whyyou disagree with the decision.You have 20 calendar days from the date of the decision to file atimely appeal. You can still appeal even if you miss the 20 daydeadline, however, you must state why your appeal is filed late. Youwill be required to show good cause for delay in filing an appeal. Ifyou do not show good cause for any delay beyond 20 days, yourappeal may be dismissed by the Administrative Law Judge.The Office of Appeals will notify you of the date, time, and place ofyour hearing. An Administrative Law Judge conducts your hearing.You have the right to review all records affecting the appeal beforeyour hearing begins. Everyone testifies under oath. All testimony isrecorded and is subject to cross-examination. The AdministrativeLaw Judge will mail a decision. If you live in another state, theappeal hearing will be handled by telephone. You do not haveto travel to California to attend the appeal hearing.If you disagree with the decision of the Administrative Law Judge,you may appeal to the California Unemployment Insurance AppealsBoard.

    If you are claiming benefits, you must continue to mail yourContinued Claim forms to EDD while your appeal is pending. Ifthe Administrative Law Judge decides you are eligible, you willonly be paid for the weeks that you sent in Continued Claimforms and met all other eligibility requirements.

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 23 of 35 CU

  • California Training Benefits

    The California Training Benefits (CTB) program allows you, ifqualified, to continue receiving UI benefits while in approvedtraining.

    If your training is funded under the Workforce Investment Act (WIA),Employment Training Panel (ETP), Trade Readjustment Act (TRA),or Work Opportunity and Responsibility to Kids (CalWORKs), youare potentially eligible for the CTB program. Contact your localOne-Stop Center for the name and location of the training providersin your area. To locate the One-Stop Center nearest you, contactEDD by using the telephone number listed on page 1 of thishandbook or visit the EDD Web site at www.edd.ca.gov.

    If you live in a state other than California and have a valid CaliforniaUI claim, your training must be funded by WIA or TRA to bepotentially eligible for CTB

    If you secure training on your own behalf or are not funded fortraining by WIA, ETP, TRA, OR CalWORKs, the Department mustdetermine if you meet all the following criteria, in order to be eligiblefor the CTB program:

    You must be eligible for California UI benefits and be out ofwork for four or more continuous weeks, or unlikely to return toyour most recent work place due to plant closure or substantialreduction in work force, or unemployed due to a mental orphysical disability preventing the use of existing job skills, orunemployed due to technological changes in your occupation.

    There must be a lack of demand for your current skills in thelocal labor market.

    There must be a demand for your training occupation in thelocal labor market.

    Your training course must be completed within one year,including scheduled breaks and vacations.

    TRAINING AND OTHER SPECIAL PROGRAMS

    REQUESTING COPIES OF YOUR UNEMPLOYMENTINSURANCE DOCUMENTS

    If, for personal business reasons, you need copies of UI claimdocuments, call the EDD Unemployment Insurance numbers listedon page 1 of this handbook.

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 24 of 35 CU

  • Your training must be full time, not less than 20 hours per week,or 12 semester or quarter units.

    It must be at least three years since your previous participationin CTB.

    CTB Training Extension Claims

    An extension of CTB training benefits may be available beyond yourregular UI claim while you are in approved training. To be eligible forextended training benefits, you must ask for information about CTB orapply for CTB training approval with EDD no later than the 16th week ofUI benefits paid. If your UI claim award is 16 weeks or less, you mustask for information or apply before you receive the last UI benefit check.To file an extended training benefits claim, call the telephone number onpage 1 of this handbook or file on-line by visiting EDD's Internet Web siteat www.edd.ca.gov, after you receive your last UI benefit check.

    Trade Adjustment Assistance (TAA) ProgramTAA benefits apply to those claimants whose employers or companiescertified for benefits on or after November 4, 2002. North American FreeTrade Agreement Transitional Adjustment Assistance (NTAA) benefitsapply to those claimants whose employers or companies certified on orbefore November 3, 2002.

    This federally-funded program offers benefits to workers unemployedbecause of imports from other countries.

    These benefits include:

    Weekly Trade Readjustment Allowances (Basic TRA) Additional Weekly Trade Readjustment Allowances (Extended TRA) Training Job Search Allowances Relocation Allowances

    Basic TRA: Pays a weekly income benefit after you have received all ofyour regular UI benefits.

    For information about training benefits or how to apply, call thetelephone number listed on page 1 of this handbook and speakwith a representative.

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 25 of 35 CU

  • Extended TRA: Pays a weekly income benefit after you have received allof your regular UI benefits and basic TRA if the following conditionsexists:

    Filed on or before November 3, 2002 You are in an approved training program Your application for such training is filed within 210 days from the

    Department of Labors decision date or your layoff date, whicheveris later.

    Filed on or after November 4, 2002 You are in an approved training program Your enrollment must be within 16 weeks of separation or 8 weeks

    of certification from the Department of Labor.

    Training: When DOL determines your job loss was caused by foreignimports, you are entitled to one job training program.Job Search Allowance: When DOL determines your job loss was theresult of foreign imports, you have 365 days from DOLs decision date oryour layoff date (whichever is later) to apply for these benefits.Relocation Allowance: If your application is timely, TAA will reimburse aportion of your relocation costs if you have secured suitable employmentin a new locality. You have 425 days from DOL's decision date or yourlayoff date (whichever is later) to apply for these benefits.The DOL will rule on eligibility for these benefits after receiving apetition filed on behalf of affected workers to determine whether joblosses occurred because of foreign imports.

    For information about training benefits or how to apply, call thephone number listed on page 1 of this handbook and speak with arepresentative.

    You may obtain a petition for TAA by calling EDD or by calling theOffice of Trade Adjustment Assistance with DOL in Washington,D.C., telephone (202) 693-3560.Petitions may be filed by three workers, their union or theiremployer, One-Stop operators or partners, State WorkforceAgencies, and State dislocated worker units.North American Free Trade Agreement Transitional AdjustmentAssistance (NTAA)NTAA benefits apply only to those claimants whose employer orcompany certified for benefits on or before November 3, 2002.

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 26 of 35 CU

  • This program offers similar benefits to those described under TradeAdjustment Assistance. However, there are some major differences.The DOL must determine you have lost your job because youremployer moved the job to Canada or Mexico, or you lost your jobbecause of imports from Canada or Mexico. To be eligible forweekly NTAA-TRA benefits you must be attending training by theend of the 16th week of your most recent qualifying layoff from yourtrade affected employer or have completed training. If you cannotmeet this requirement, you still may be eligible for weeklyNTAA-TRA benefits if you are attending approved training by theend of the sixth week after DOL determines you are an affectedworker.

    You may obtain a petition for NTAA from any EDD office. Petitionsmay be filed by three workers, their union, their employer, or acommunity-based organization.

    For additional information about these programs, call EDD.Federal-State Extended Benefits ProgramThe Extended Benefits program becomes effective ONLY whenunemployment is very high. This program pays additional benefitsto those who qualify and have collected all the money in theirregular claims and are not eligible for any other UI claims. THE EDDWILL NOTIFY YOU, by mail and/or through the media, when youbecome potentially eligible for this benefit.

    Under Title 18 of the United States Code, Section 1001, willfully andknowingly concealing a material fact by any trick, scheme, or device,or knowingly making a false statement in connection with anExtended Benefits claim, is a Federal offense. You can be punishedwith a fine of not more than $10,000 or imprisoned for not morethan five years or both.

    Disaster Unemployment Assistance (DUA)Individuals whose work or self-employment is interrupted becauseof a disaster and who are not eligible for UI or Disability Insurancebenefits, may be eligible for DUA benefits. You can file a claim afterEDD announces that DUA benefits are available.

    Work Sharing (WS)The WS program gives employers an alternative to reducing theirwork force. Before the enactment of the WS program, if employershad to reduce their work force, they had no choice but to lay offworkers. Under Californias WS program, employers can file WSplans with EDD to reduce the work week of participating employees.DE 1275A Rev. 43 (11-04) (INTERNET) Page 27 of 35 CU

  • Participating employees could receive reduced UI weekly benefitscorresponding to the percentage reduction of their work hours.

    Everyone benefits under the WS program. Employers keep trainedworkers during a slowdown and employees keep their jobs.Partial Claims

    Some employers participate in the partial claims program. Theseemployers give the Notice of Reduced Earnings, form DE 2063, totheir full-time employees:

    Who are laid off for no more than two consecutive weeks, or Whose gross earnings, when reduced by $25 or 25 percent,

    whichever is greater, are less than their weekly benefit amount.

    Employees use a DE 2063 form to claim benefits instead of theregular Continued Claim form. Mail the form in the envelopeprovided. The DE 2063 form represents a seven-day period,usually based on the employers payroll week. Employees remainattached to the employer and do not have to look for other work,but must be able to work and available for work.

    OTHER EDD SERVICES

    Job Services

    At EDD Job Service and partner sites, you can enroll in theCalJOBSSM Internet based job and rsum listing system. WithCalJOBSSM you can produce a quality rsum and view a widevariety of job listings within your city or anywhere in the State. If youhave Internet access you can also enroll at www.caljobs.ca.gov TheJob Service sites can also provide you with information about labormarket conditions, services to veterans, and programs to assistthose with barriers to employment. Information on servicesavailable, as well as locations of Job Services offices, can be foundon EDD's Internet Web site at www.edd.ca.gov.

    These services are provided at no cost and are available to jobseekers who are legally entitled to reside and work in the UnitedStates. For more information, contact the local EDD Job Serviceoffice listed in the Government Pages of your telephone directory, orby calling EDD.

    Reemployment Services

    California has a system to identify claimants for whom few jobopenings exist and who are, therefore, likely to exhaust theirbenefits. The EDD schedules those individuals most in need of

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 28 of 35 CU

  • assistance to an orientation to reemployment services. Once youhave been scheduled for an orientation to reemployment servicesinterview, failure to attend can result in loss of UI benefits.

    One-Stop Services

    Comprehensive One-Stop Centers provide access to a full range ofservices pertaining to employment, training and education,employer assistance, and guidance for obtaining other assistance.One-Stop Career Centers use varied strategies in providing theappropriate services to meet the needs of their customers.Californias Job Service is an integral partner in the One-StopCareer system.

    Information and county-by-county listings of all California One-StopCareer Centers and access points including addresses, phonenumbers, and hours of operation can be accessed on the Internet,at http://www.edd.ca.gov/one-stop.

    Core Services are available and include, in part, labor marketinformation, initial assessment of skill levels, and job searchplacement assistance.

    Intensive Services are available to eligible unemployedindividuals who have completed at least one core service, buthave not been able to obtain employment, or employedindividuals needing additional services to obtain or keepemployment that will lead to personal self-sufficiency.

    Training Services are available to eligible individuals who havemet the requirements for intensive services and have not beenable to obtain or keep employment. Individual Training Accountsare established to finance training based upon the individualschoice of selected training programs.

    Americas Workforce Network (AWN)If you need information about finding jobs and job training in yourcommunity, call the AWN Toll-Free Help Line or visit AmericasService Locator on-line. Most of the services that may help you getback to work are available through your local One-Stop CareerCenter. The AWN Toll-Free Help Line and Americas Service Locatorcan help you find the location of the center nearest you.

    Local services that may be available include:

    Assessment and counseling Job search and placement assistance

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 29 of 35 CU

  • Information about local education and training providers Access to computers, telephones, and fax machines

    Toll-Free Help Line 1-877-US2-JOBS (1-877-872-5627)Americas Service Locator www.servicelocator.org

    Disability Insurance (DI)Californias State Disability Insurance program has two parts, StateDisability Insurance (SDI) and Paid Family Leave (PFL). SDIprovides benefits to eligible workers who have a wage loss becausethey are unable to do their regular work due to illness or injuryunrelated to work, or pregnancy. Effective July 1, 2004, PFLbenefits will be paid to eligible workers who take time off work tocare for a seriously ill child, spouse, parent, domestic partner, or tobond with a new minor child. You can obtain an SDI or PFL claimform by telephoning the SDI or PFL office at the toll-free numbersbelow. You can also obtain these forms on EDDs Internet Web siteat www.edd.ca.gov.

    EDD State Disability Insurance (SDI) Toll-Free Numbers:English 1-800-480-3287Spanish 1-866-658-8846

    TTY (Non Voice) 1-800-563-2441EDD Paid Family Leave (PFL) Toll-Free Numbers:

    English 1-877-BE THERE (1-877-238-4373)Spanish 1-877-379-3819

    TTY (Non Voice) 1-800-563-2441

    OTHER IMPORTANT INFORMATION

    Child Support Intercept

    If you are delinquent in paying a child support obligation that hasbeen filed with a court, we will withhold 25 percent of your weeklybenefits. The money will be sent to the Department of ChildSupport Services Local Child Support Agency that is enforcing thechild support order. If you have child support obligations in morethan one county, the money deducted from your benefits will go tothe county that filed first. Contact the office of the Local ChildSupport Agency if you have questions about child supportdeductions or distribution of the money.

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 30 of 35 CU

  • Fraud Prevention and Detection

    The EDD recognizes your concerns about imposter fraud and thethreat of identity theft. Imposter fraud occurs when someoneintentionally files a UI claim using another persons employment orpersonal information. EDD actively investigates cases of imposterfraud and is committed to protecting the identities of legitimateclaimants. To assist in these efforts, if there is reason to suspect aUI claim may have identity or imposter issues, you may receive aRequest for Identity Verification (DE 1326C) requesting you tovalidate the information provided when you filed for UI benefits. TheDepartment will contact employers(s) and governmental entities toverify the documents and any information you supply.

    To learn about what steps you can take to protect your identity andprevent imposter fraud, download the Protect Your Identity and StopUnemployment Insurance Imposter Fraud (DE 2360EE) brochurefrom EDDs Web site at www.edd.ca.gov/uirep/uipub.htm or call(916) 255-1743 to request a copy.Verification of Right to Work

    The Immigration Reform and Control Act of 1986 requires EDD toreview the citizen or alien status of all UI claimants. When you file aclaim or reopen your present claim, we must ask you to declare,under penalty of perjury, whether you are a citizen or national of theUnited States, or an alien in a satisfactory immigration status.Satisfactory immigration status means that you are lawfully residingin the United States and are legally authorized to work.

    If you are not a United States citizen, you will be asked to provideproof of your immigration status and work authorization.

    This may include, but is not limited to:

    Your alien registration card, or

    Other document(s) issued by the United States Citizenship andImmigration Services (USCIS), or

    Any document(s) you consider to be proof of your satisfactoryimmigration status.

    The document(s) you present will be verified with USCIS. You willalso be asked to make a declaration about your citizenship orimmigration status during the period you earned the wages onwhich your claim is based.

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  • Alien claimants must show continuing work authorization from theUSCIS. The documents must be presented to the EDD before theexpiration date. Once the work authorization has expired and theEDD has no evidence that the work authorization has beenextended, the EDD can no longer pay benefits. Benefits will bedenied from the expiration date until the extension document isprovided.

    Whether you are a citizen, national, or alien, you must be ready andable to establish your right to work when you are hired. You may bedenied benefits for any week in which we find that you are unable toestablish your right to work in the United States.

    Verification of Social Security Account Number

    The EDD may require you to verify your social security accountnumber as being the one issued to you by the Social SecurityAdministration (SSA) if the information available to EDD indicatesthat the social security account number presented by you maybelong to another individual, is not a valid social security accountnumber, or was never issued by the SSA, or that the wages shownin the base period of the claim may belong to another individual.

    Some of the most common errors associated with social securityaccount numbers are:

    The SSN being used is incorrect. You may have forgotten thenumber or transposed the number when you provided it to youremployer.

    The name at the SSA is different than the one you used to fileyour claim. You may have changed your name and not notifiedthe SSA.

    The date of birth at the SSA is different than the date of birthyou gave when you filed your claim.

    If the EDD requires you to verify your social security account num-ber, which you provided to EDD during the claim application, youmust submit verification of your social security account numberthrough the SSA, or you may submit to EDD a copy of your annualstatement issued to you by the SSA. A copy of your Social SecurityCard will not satisfy this requirement. The location of your nearestSSA office can be found on the SSA Web site at http://www.ssa.gov/reach.htm, or in your local telephone book in the Federal Govern-ment listing under Social Security Administration.DE 1275A Rev. 43 (11-04) (INTERNET) Page 32 of 35 CU

  • ConfidentialityAlthough federal and state laws prohibit the revealing of informationabout your employment and your UI claim to your spouse, relatives,friends, non-interested parties, and private interest groups, federallegislation requires that such information be made available to stateand federal Welfare, Medical Assistance, Food Stamps, Housing,and Child Support Enforcement agencies. Confidentiality is theresponsibility of all agencies using the information.

    Privacy Act Statement

    The Privacy Act of 1974 requires that you be furnished thisstatement because you are asked to provide your Social Securitynumber when filing a UI claim. Your Social Security number isrequested under the authority of the Internal Revenue Code of1954 (26 U.S.C. 85, 6011(a), 6050B, and 6109(a)). Disclosure ofyour Social Security number for this purpose is mandatory. Shouldyou decline to disclose your Social Security number, your claim forUI benefits will not be processed.

    Your Social Security number will be used (1) to process your claimand determine your eligibility for UI, (2) to report yourunemployment benefits to the Internal Revenue Service (IRS) asincome, (3) for statistical purposes, (4) for cross matching by publicassistance agencies or other governmental entities in the officialperformance of their duties.

    Telephone Services

    Many EDD services can be accessed by telephone. The InteractiveVoice Response System (IVR) provides general information24 hours a day and information about your check Monday throughSaturday, 6 a.m. until midnight, and Sunday from 6 a.m. to 9 p.m.,Pacific Standard Time. Unemployment Insurance check informationincludes the date your last check was issued, the amount paid, andperiod of time paid. To access your check information, you will beasked to enter your social security number and a personalidentification number, called a PIN on your telephone keypad. Youwill establish your PIN the first time you use the IVR to access yourcheck information. The EDD's Interactive Voice Response Systemprovides step-by-step instructions to guide you to services youwant, in English and Spanish. For faster access to checkinformation, it is best to call outside of regular businesshours.

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 33 of 35 CU

  • Missed appointments, appeals, overpayments, and UI claiminformation are handled by customer service representatives atInformation Call Centers Monday through Friday, 8 a.m. to 5 p.m.Monday and Tuesday are usually our busiest days. For fasterservice, call us Wednesday or Thursday to file your claim or toinquire about your claim. You must, however, call by Friday of theweek in which you become unemployed to receive credit for thatweek.

    Outside California: If you reside in another state and your UI benefitclaim is against California (California is the state paying the benefitsto you) the same telephone services as described above areavailable to you. The toll-free telephone number for a CaliforniaInterstate claim is: 1-800-250-3913.

    For information on employment services in your state, check theGovernment Pages of your local telephone directory under StateGovernment Offices. Remember that other states have differentnames for their employment services. In some states the localemployment service may contact you directly about job registrationand job search services.Telephone Services for the Deaf, Hard of Hearing, and Speech-Disabled

    Deaf and hard of hearing customers can call EDD direct on TTY tofile for unemployment benefits or get current information on theirunemployment claim. Call the TTY number 1-800-815-9387,between 8 a.m. and 5 p.m. Pacific Standard Time, Monday throughFriday. TTY users and people with speech disabilities can also usethe California Relay Service (CRS) to contact EDD. Provide theCRS with the EDD phone number on page 1.

    NOTE: The TTY 800 number does not accept voice calls.

    Internet Services

    Internet Claim FilingFile your UI claim the fast and easy way using eApply4UI, EDDsInternet application. eApply4UI is reliable and secure, and isavailable in English or Spanish, 24 hours a day. Access eApply4UIon the Internet at www.edd.ca.gov/eapply4ui or athttps:\\eapply4ui.edd.ca.gov.

    Other Internet ServicesAccess EDDs home page at www.edd.ca.gov to learn more aboutservices the Department provides.

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 34 of 35 CU

  • Federal Income Tax and Unemployment Insurance Benefits

    Unemployment Insurance is taxable income and must be reportedon your federal income tax return. The EDD will mail you a form1099G that states the amount of benefits paid to you during theprevious year. The 1099G form should arrive by January 31. If youdo not receive the 1099G form, you may request a duplicate bycalling 1-800-795-0193 or write to EDD, Insurance AccountingDivision, MIC 24, P.O. Box 2408, Rancho Cordova, CA 95741-2408.Be sure to include your name, social security number, mailingaddress, and the year for which you are requesting a duplicate1099G. If you have questions regarding the taxability of UI benefits,contact the IRS.

    Voluntary Federal Income Tax WithholdingYou may request that federal taxes be withheld from your benefitchecks. This option is strictly voluntary; you are not required tohave taxes withheld from your benefits. Some important points toconsider when you make this choice:

    Unemployment compensation is subject to federal income tax.Annually, the EDD will report your benefits to the IRS.

    Requirements exist pertaining to estimated tax payments.Failure to pay required estimated income tax may result infederal income tax penalties.

    If you elect to have federal income taxes withheld, the adjustedweekly benefit amount is your weekly benefit amount minusdeductions due to wages earned, illness, or certain otherreasons.

    1099G

    Form 1099G will also show the total federal taxes withheld, if any. Ifyou have questions concerning your tax liability, contact the IRS.

    DE 1275A Rev. 43 (11-04) (INTERNET) Page 35 of 35 CU

  • The California State Employment Development Department (EDD) is a recipient offederal and state funds, is an equal opportunity employer/program, and is incompliance with Section 504 of the Rehabilitation Act and the Americans withDisabilities Act (ADA).Special requests for alternate formats need to be made by calling the informationnumber listed inside the front cover of this brochure.

    DE 1275A Rev. 43 (11-04) (INTERNET) Back Cover + 35 Pages CU/GA 791B