Notice of Potential Overpayment

Our information shows that you may have been overpaid $

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in unemployment benefits. An overpayment is when you receive benefits you are not eligible for. If you do not agree with the information on this form, you must contact us by

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and provide the reason why you disagree. If you do not contact us, we will assume our information is correct and will mail you a Notice of Overpayment with the amount you must repay.

Important: If box B is checked on the bottom of this form, you can apply for an overpayment waiver. Complete and return the attached Application for Overpayment Waiver (DE 1446UI) to the address or fax number below by

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If you do not agree with the information on this form, contact us by

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By Mail:

Insert Address.Blank line
By Fax:

Insert Fax No.Blank line
By Phone:

English and Spanish:

1-800-300-5616

Cantonese:

1-800-547-3506

Mandarin:

1-866-303-0706

Vietnamese:

1-800-547-2058

California Relay Service (711): Provide the UI number

(1-800-300-5616) to the operator

TTY:

1-800-815-9387

Our information shows:

You were notified onBlank line in the Notice of Appeals and Transmittal of Appealed Decision (DE 6315) that you would be paid benefits until an appeal decision was made. As a result of the appeal decision, you are not eligible for those benefits, and they are an overpayment.
You were notified on Blank line in the Notice to Claimant Regarding Benefits Paid Pending Appeal (DE 6315A) that you would be paid benefits until an appeal decision was made. As a result of the appeal decision, you are not eligible for those benefits, and they are an overpayment.
On Blank line , you returned Notice of Right to Receive Unemployment Insurance Benefits Pending Appeal (DE 6315CC). You chose to be paid benefits until an appeal decision was made and acknowledged you may be responsible for repaying those benefits. As a result of the appeal decision, you are not eligible for those benefits, and they are an overpayment.

Important information on other side of this notice.

DE 1447ALJ Rev. 3 (9-22) (INTRANET)

SAMPLE, this page for reference only

You were notified on Blank line in the Notice of Conditional Payment Pending Eligibility (DE 5400E) that you would receive conditional payments until we determine your eligibility. As a result of the eligibility decision, you are not eligible for those benefits, and they are an overpayment.
You requested a duplicate check on Blank line for Blank line Dash – Blank line Both checks were cashed. As a result, the duplicate check is an overpayment.
Other:

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Additional information:

If we determine that you intentionally gave false information or withheld information, the overpayment is considered fraud. You will have to pay a 30-percent penalty of $Blank line in addition to the amount shown above. If you would like to provide information about this potential false statement, answer questions on the enclosed Notice of Potential False Statement, sign and date the notice, and return it to the EDD.
Our current information shows that you can apply for an overpayment waiver. Complete and return the attached Application for Overpayment Waiver (DE 1446UI) to the address or fax number above by Blank line

SUS DT:

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B (

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)

DE1447ALJ

(01/08/01)

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DE 1447ALJ Rev. 3 (9-22) (INTRANET)

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UI / DE 1447ALJ

Notice of Potential Overpayment