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UI / DE 400-A
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SAMPLE
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Date
Blank Space
Code
Blank Space
Name
Blank Space
Address
1
Blank Space
Address
2
Blank Space
Dear
Blank Line
,
This is in response to your letter dated
Blank Line
concerning your overpayment of benefits.
In order to answer your questions, please provide the following information:
Name
Blank Space
Claimant ID
Blank Space
Claimant’s Social Security Number
Blank Space
Daytime Phone Number
Blank Space
Please contact us at the number below or return this letter immediately to the following address:
Attention: Overpayment Adjustment Unit
Employment Development Department
Overpayment Accounting and Reporting Group, MIC 8
PO Box 2588
Rancho Cordova, CA 95741-2588
If you have any questions regarding this letter, contact us at
1-916-464-2333
.
Sincerely,
Blank Space
Overpayment Adjustment Unit
Overpayment Accounting and Reporting Group
EDD/IAD, MIC 8
PO Box 2588, Rancho Cordova, CA 95741-2588
1-916-464-2333
DE 400-A Rev. 1 (5-22)
(INTRANET)
Email Address:
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