Fillable Printable Request For Identity Verification (De 1326C)

Request For Identity Verification (De 1326C)

SAMPLE

You are receiving this notice because the Employment Development Department (EDD) is unable to

verify your identity. The information you provided when you filed your unemployment insurance claim

did not match the information available to the Department or the Department received information that

indicated your identity may have been compromised. When there is a question of correct identity, the

Department requires identifying documents to verify that unemployment benefits are paid only to those

who are legally entitled to receive them.

Enclosed with this notice is a list of docum ents you must provide to verify your identity.

Your eligibility for unemployment insurance benefits is pending receipt of these documents. The

Department will contact employer(s) and governmental entities to verify the documents and any

information you supply. If you do not supply the documents or the documents/information do not allow

the Department to establish your identity, you will not be eligible to receive benefits.

In order to receive benefits you must provide your 9-digit Social Security number (SSN) as provided to

you by the Social Security Administration (SSA). Please check your records and verify that the SSN

listed on this notice is the one issued to you by the SSA. If the information available to the Department

indicates the SSN you provided is not verified to you by the SSA, you may be required to contact the

SSA to obtain verification of your SSN and then send a copy to the EDD at the office address listed

above. The location of your SSA office can be found on the SSA website at

https://www.socialsecurity.gov/locator or in y our local telephone book in the Federal Government

listings under “Social Security Administration.”

Please SIGN

and retur n this docume n t in the bl u e e n ve lo pe pr ovided al ong with clear and readable

identity verification documents within 10 ca lendar days from the mail date of this document. Your

complete Social Security number must be on each document you submit.

NOTE: DO NOT

INCLUDE ANY OTHER DEPAR TMENT FORMS IN THE BLUE ENVELOPE AS IT

WILL RESULT IN DELAYS.

On page two is a list of the required identity documents you must provide. There are also

instructions on what to do if you need m ore time to provide the documents.

DE 1326C Rev. 7 (3-13) (INTERNET)

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Mail Date:

SSA No.:

EDD TOLL FREE TELEPHONE NUMBER:

1-866-401-2849

REQUEST FOR IDENTITY VERIFICATION

Name and Address of Claimant

I understand the law provides penalties if I make false statements or withhold facts to obtain benefits; I declare

under penalty of perjury that the information I am providing and the documents I am submitting are true and

correct and belong to me.

PRINT YOUR NAME SIGNATURE DATE

(YOUR signature is required)

SSN NO.:

EMPLOYMENT DEVELOPMENT DEPARTMENT

PO BOX 2530

RANCHO CORDOVA, CA 95741-2530

Claimant Name

Claimant Mailing Address

Claimant City, State, ZIP

SAMPLE

REQUIRED IDENTITY DOCUMENTS

Some of the most common errors associated with SSNs are:

 The SSN being used is incorrect. You may have forgotten the number or transposed the number

when y ou provided it to your employer.

 The name at the SSA is different than the one yo u used to file your claim. You may have changed

your name and not notified the SSA.

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

You m ust provide a clear and readable copy of ONE PHOTO IDENTIFICATION. (See enclosure

for a list of acceptable documents.)

AND

You must also provide ONE OR MORE clear and readable DOCUMENTS LISTED BELOW.(See

enclosure for a list of the acceptable documents.)

1. Employment Data

2. Address Verification

3. Social Security Number Verification

(A copy of your Social Security Card

will not satisfy this requirement.)

4. Date of Birth Verification (official copy of birth certificate)

FAILURE TO COMPLY WITH THIS REQUEST FOR IDENTITY VERIFICATION WITHIN 10

CALENDAR DAYS FROM THE MAIL DATE OF THIS FORM MAY RESULT IN A DENIAL OF

BENEFITS. PLEASE INCLUDE YOUR COMPLETE SSN ON ALL DOCUMENTS SUBMITTED.

You have the right to request more time to gather documents or obtain the advice of a

representative. If you need more time, you must contact the Department WITHIN 10 CALENDAR

DAYS from the mail date of this form to request the additional time. You may contact the

Department by mail or telephone at the EDD address/number listed on page one. If at the end of the

10 days the documents are not received or an extension is not requested, an eligibility decision will

be made based on the available information.

The California Unemployment Insurance Code (CUIC) Section 1253(a) states all claims for

unemployment insurance benefits must be filed in accordance with Department regulations. The

CUIC Section 1257(a) states that if an individual gives false information to the Department in order

to obtain unemployment insurance benefits, the individual may be subject to a penalty. Title 22,

California Code of Regulations, Section 1326-2 (b)(2)(A) states the Department may require a

claimant to verify the SSN as being the one issued to him or her by the SSA if the information

available to the Department indicates that the SSN may belong to another person or is not a valid

number.

DE 1326C Rev. 7 (3-13) (INTERNET)

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