After you have marked your choice, mail the form to the Employment Development Department in the enclosed envelope or mail to the Field Office address listed above. The completed form must be mailed no later than
Blank line
.
If we do not receive this form within ten (10) days of this date, we will file your claim with the beginning date of
Blank line
, since this is the date your claim would normally begin, based on the date you mailed in your application.