Fillable Printable Notice Of Unemployment Insurance Award (De 429Z)
Fillable Printable Notice Of Unemployment Insurance Award (De 429Z)
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Notice Of Unemployment Insurance Award (De 429Z)
![](/resources/formfile/htmls/gov1218/notice-of-unemployment-insurance-award-de-429z/bg1.png)
EDD Call Center
PO Box
City, CA ZIP Code
Mail Date: 00/00/0000
SSN: 000-00-0000
EDDPhoneNumbers:
English
Spanish
Cantonese
Mandarin
Vietnamese
TTY (nonvoice)
website:
1-800-300-5616
1-800-326-8937
1-800-547-3506
1-866-303-0706
1-800-547-2058
1-800-815-9387
www.edd.ca.gov
Claimant's Name
Claimant's Address
City, CA ZIP Code
NOTICE OF UNEMPLOYMENTINSURANCEAWARD
Claim BeginningDate:
Maximum Benefit Amount:
Total Wages:
00/00/0000
$0000
00,000.00
2.Claim Ending Date:
00/00/0000
$000
0,000.00
1.
3.
5.
7.
8.
4.
Weekly Benefit Amount:
6.Highest Quarter Earnings:
This itemdoes notapplytoyour claim. For moreinformation, seeitem 7 on the reverse.
You mustlook for fulltimework eachweek.For more information, refer to thehandbook,
AGuide to Benefits
and Employment
Services
, DE1275A, available online at www.edd.ca.gov/forms/.
This itemdoes notapplytoyour claim.
This ClaimAward is calculated basedon the(Standard orAlternate)Base Period.
9.
10.
Important InformationOnNext Page
DE 429Z Rev.9(9-15)(INTERNET)
Page 1 of 2
CU
11. Employee Name:
12. Employee Wages for the Quarter Ending:
13. Employer Name:
Month/YearMonth/YearMonth/YearMonth/Year
Claimant's Name
0,000 0,000 0,000 0,000
ABC CO
14. TOTALS:
0,0000,0000,0000,000
SAMPLE
![](/resources/formfile/htmls/gov1218/notice-of-unemployment-insurance-award-de-429z/bg2.png)
DE429ZRev.9(9-15)ImportantInformationOnNextPageCU
THEFOLLOWINGISADDITIONALINFORMATIO NREGARDINGTHEITEMSONTHEREVERSEOFTHISPAGE
1.ClaimBeginni ngDate:Thedateyourclaimbegins.
2.ClaimEndingDate:
Thedateyourclaimends.
3.MaximumBenefitAmount:
Thetot alamountofmoneyy oucanreceivefromthisclaim .
4.WeeklyBenefitAmount:Themaximumamountyoucanbepaideachweek,ifyoum eettheweeklyeligibilityrequirem ents.
5.To
talWages:Thetotalamountofearningsreportedbytheempl oyer(s)duringthequarterslistedonthereversepageini tem12.
Theseear ningswereusedtocomputeyourmaximumbenefi tamount.
6.HighestQ
uarterEarnings:Thecalendarquarterlist edont hereversepageinitem12wit hthehighestamountofear nings.These
earningsdeter mineyourweeklybenef itam ount.
7.Theawardlistedonthereversepageinitem7i syourawardwithoutthewagesearnedfromapublicornonprofitschool.Ifyou
workedforapublicornonprofitschoolduringanyofthequarterslistedonthereversepageinitem12,youmaynotbeabletouse
thosewagesinyourclaimduringaschoolrec essperiod.
8.Youmustfoll owtheinstructionsonthereversepageinitem8tobeeligibleforbenefits.Bylawyoumustmakeal lr easonableefforts
tofindworkwhenclaimingbenef its.
9.TheUnempl oymentInsuranceCode(Section1277)requirest hatyouworkbetweenthebeginningandtheendingdatesofaprior
claimtohaveavalidclaimt henextyear.Ifthisappliestoyourclaimyouwillreceiveadditionalinstructions.
10.Thetypeofbaseperiodusedtoestablis hyourclaim;itwillbeei thert heStandardBasePeriodortheAlternateBasePeriod.Ifyou
donothavesufficientwagesintheStandardBasePeriodtoestablishavalidclaim,youmaybeeligibletousetheAlternateBase
Period.Formoreinformation,reviewthehandbook,AGUIDETOBENEFITSANDEMPLOYMENTSERVICES,DE1275A,available
atwww.edd.ca.gov/forms/
.
11.Employee
'sName:Thenameusedbyyouremployer(s)toreportyourearningstotheEmploymentDevelopmentDepartment(EDD)
duringeachcalendarquarterlist edont hereversepageinitem11.
12.Employee
'sWagesfortheCalendarQuarterEndi ng:Thesearethepotentiallyusablewagesf orunemploymentinsurancepurposes
thatyouremployer(s)reportedyouearnedduringeachcalendarquar terlisted.Theseearningsdeter mi netheamountofyour
UnemploymentInsurance(UI)award.
13.EmployerName:Thename(s)oftheempl oyer(s)youworkedforduringthecal endarquarterslistedonthereversepageonitem13.
14.Totals :
Thetotalamountofearningsreportedbyallemployer(s)ineachcal endarquarterlistedonthereversepageinitem12.
YOURCLAIMISINVALIDIF:
a.Yourearningswerenotenoughtomeettheminimumrequirements.
b.YouhadapriorUIclaimanddidnotmeettherequirementsforworki ngandearningwagesnecessarytohavealatervalidclaim.
IMPORTANT:
Checkthisnoticecarefullytomakesurethatallempl oyersyouworkedfori nthecalendarquartersshown,(onthereversepagein
item12)arelistedandt hatt hewagesyouearnedareshown.Ifanemployerislistedandyoudi dnotworkforthem,orifanempl oyeris
notlisted,oryourwagesareincorrect,contactanEDDofficeimmediatelyt oprotestt heaccuracyofthecomputation.Youmaybe
subjecttodisqualifications,overpayments,and/orcri mi nalpenal tiesforfailuretonotifytheEDDimmediatelyofanyinaccurate
empl oymentandwageinformationdisplayedinitem12.
Ifyouworkedforafederalagencyyourwagesmustberequestedfromthatfeder alagency.YouwillreceiveaNoticeofAmended
UnemploymentInsuranceAwa
rdwiththesewagesadded.
Ifthisnoticeoramendednoticei sincorrectandyouwanttoprotesttheaccuracyofthecomputationorrec omput at ion,youmustcont act
theEDDwithin30daysafterthem aildateofthenoticeoramendednotice.Otherwise,awageinvesti gationorrecomputati onofwages
maybedenied.The30-dayperiodmaybeextendedforgoodcause.Ifyouneedtocont acttheEDD,youwillneedtoprovideyourf ull
name,address,andSocialSecurit ynumberand,ifnecessary,anywageandemploymentinformationyouwoul dliketoaddtoyour
claim,ortorem oveanyemployersforwhomyoudidnotworkandearnwages.
YOUARERESPONSIBLEFORKNOWINGTHECONTENTOFTHEUNEMPLOYMENTINSURANCEBENEFITS:WHATYOUNEED
TOKNOW,DE1275B,ANDTHECONTENTOFTHEHANDBOOK,AGUIDETOBENEFITSANDEMPLOYMENTSERVICES,
DE1275A.BOTHPUBLICATIONSEXPLAINYOURUNEMPLOYMENTRIGHTSANDRESPONSIBILITIESANDAREAVAILABLEAT
WWW.EDD.CA.GOV/FORMS/
.
TORECEIVEUlBENEFITS,YOUMUSTCERTIFYFORBENEFITSUSINGONEOFTHEFOLLOWINGM ETHODS:UIONLINE
SM
,
EDDTELE-CERT
SM
,ORSUBMITAPAPERCONTINUEDCLAIMFORM,DE4581.FORMOREINFORMATIONONCERTIFYING
FORBENEFITS,REFERTOTHEDE1275AHANDBOOKWHICHISAVAILABLEONLINEATWWW.EDD.CA.GOV/FORMS/.
DE429ZRev.9(9-15)(INTERNET)
MailDate:
dte001
SSN:
str002
EDDPhoneNumbers:
English1-800-300-5616
Spanish1-800-326-8937
Cantonese1-800-547-3506
Mandarin1-866-303-0706
Vietnamese1-800-547-2058
TTY(nonvoice)1-800-815-9387
website:
www.edd.ca.gov
11.EmployeeName:12.EmployeeWagesfortheQuarterEnding:13.EmployerNam e :
str037
str038str039str040
arr_str045
arr_str046arr_str047arr_str048arr_str049
arr_str050
14.TOTALS:
str041
str042str043str044
1.
ClaimBeginni ngDate:dte010
2.
ClaimEndingDate:dte030
3.
MaximumBenefitAmount:str031
4.
WeeklyBenefitAmount:str032
5.
TotalWages:str035
6.
HighestQuarterEarnings:str036
7.
str133
8.
rtf029a
9.
rtf057a
10.
ThisClaimAwardiscalculatedbasedonthestr158
BasePeriod.
str013
str014
str015str016str 017
str004str005str003
str006
str007str008str009
NOTICEOFstr160UNEMPLOYMENTINSURANCEAWARD
SAMPLE
HOWTOCANCELAUICLAIM
YouhaveanoptionofcancellingaregularCaliforniaUIclaimafteryouhavebeenmailedyourUnemploymentInsuranceAward
notice.Ifyouwanttocancelyourclaim,youneedtocontacttheEDDrightaway.DonotcertifyforUIbenefitsusingUI Online
SM
,
EDD Tele-Cert
SM
,orbysubmittingapaperContinuedClaimForm,DE4581.ThelawonlyallowsyoutocancelaUIclaimifnobenefits
havebeenpaid,nonoticeofdisqualificationhasbeenmailedtoyou,nooverpaymenthasbeenestablishedontheclaim,andthe
benefityearofyourclaimhasnotended.Iftheclaimiscancelled,itcannotbereopened.Youmustfileaclaimwithalaterdate.
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