Fillable Printable Notice Of Unemployment Insurance Award (De 429Z)
Fillable Printable Notice Of Unemployment Insurance Award (De 429Z)
Notice Of Unemployment Insurance Award (De 429Z)
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
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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