UI / DE 1180PA

SAMPLE, this page for reference only

EDD Phone Numbers:
English:
1-800-300-5616
Spanish:
1-800-326-8937
Cantonese:
1-800-547-3506
Mandarin:
1-866-303-0706
Vietnamese:
1-800-547-2058
TTY (Non-Voice):
1-800-815-9387
EDD Internet Site:
www.edd.ca.gov
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Date: MM/DD/YYYY

CALIFORNIA UNEMPLOYMENT INSURANCE (UI) WAGE AND POTENTIAL AWARD INFORMATION

Name
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The potential award of a UI claim if filed with effective date MM/DD/YYYY would be:

  • Potential Maximum Benefit Amount:
    $Blank line 
  • Potential Weekly Benefit Amount:
    $Blank line 

PLEASE NOTE – The above award is based on the Standard Base Period and is subject to change pending verification of wages and the date the claim is actually filed. School employees may have a reduced award per Section 1253.3 of the California Unemployment Insurance Code.

Calculation of Award Information

The effective date of a UI claim is the Sunday of the week the EDD was contacted to file the claim. The effective date of a claim determines the base period, and as a result, the benefit amount of the claim. The potential award listed above is based on the earnings displayed below:

Quarter/Year Blank space Blank space Blank space Blank space Employer Name
Total Wages $ $ $ $ Blank space

If the potential award listed above is $0.00 (zero) and you worked between MM/DD/YYYY and MM/DD/YYYY you may be eligible to file a UI claim using the Alternate Base Period (ABP). To determine whether you are eligible to file an ABP claim, you must contact the EDD.

If a claim is filed in: The Standard Base Period is: *The Alternate Base Period is:
Jan, Feb, Mar Oct 1 – Sep 30 Jan 1 – Dec 31
Apr, May, Jun Jan 1 – Dec 31 Apr 1 – Mar 31
Jul, Aug, Sep Apr 1 – Mar 31 Jul 1 – Jun 30
Oct, Nov, Dec Jul 1 – Jun 30 Oct 1 – Sep 30

*The Alternate Base Period is only available when you do not monetarily qualify to file a UI claim using the Standard Base Period.

To file a claim, submit an application using the eApply4UI form located on the EDD website at www.edd.ca.gov or call the EDD. Your eligibility for UI benefits will be determined after the claim is filed.

CONFIDENTIALITY NOTICE:
This notice is for the sole use of the intended recipients. It contains confidential or sensitive information. Under Penal Code 502 and Civil Code 1798.53, any unauthorized review, use, disclosure, or distribution of the content of this document is prohibited and subject to criminal penalties/fines. If you are not the intended recipient, please contact the EDD.

DE 1180PA Rev. 3 (2-18) (INTRANET)