DE 1159P

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EDD Employment Development Department State of California Logo

Date

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PLEASE FOLLOW THE INSTRUCTIONS CHECKED FOR A, B OR C BELOW

A. The enclosed Partial Form (DE 2063) cannot be accepted because you must file a new claim. TO FILE A NEW CLAIM, CALL THE TELEPHONE NUMBER IN THE WHITE PAGES OF YOUR LOCAL TELEPHONE DIRECTORY UNDER “STATE GOVERNMENT, EMPLOYMENT DEVELOPMENT DEPARTMENT (EDD).” YOU MUST CALL BETWEEN 8:00 AM AND 12 noon MONDAY THROUGH FRIDAY.
B. No earnings were reported on your partial form for the consecutive weeks ending MM/DD/YYYY and MM/DD/YYYY. For further benefits, unless you worked in the week from MM/DD/YYYY to MM/DD/YYYY, it is necessary to CALL THE EMPLOYMENT DEVELOPMENT DEPARTMENT (EDD) TO REOPEN YOUR CLAIM.
FAILURE TO FILE YOUR CLAIM WITHIN 14 DAYS OF THE DATE OF THIS LETTER MAY RESULT IN A DENIAL OF BENEFITS.
C. The enclosed form cannot be accepted because it is incomplete or incorrect. Please follow the instructions checked below and mail the partial form in the enclosed pre-addressed envelope.
1. 1. Please complete the items marked in red on the back of the form.
2. 2. Have your EMPLOYER complete the items marked in red on the front of the form.
3. 3. This form is void because it was issued or mailed before the payroll weekending date in item #1 was over. Please have your employer complete and issue a new form to you.
4. 4. Previous partial forms submitted by you from the same employer indicate a payroll weekending on a Blank Line________________. This form shows a payroll weekending on a Blank Line________________. Please return the form to your employer for correction. Your payroll weekending day may not be changed during a continuous period of drawing unemployment benefits.

FAILURE TO RESPOND WITHIN 14 DAYS OF THE DATE OF THIS LETTER MAY RESULT IN A DENIAL OF BENEFITS.

Thank you for your cooperation.

Employment Development Department

Central Authorization Center Address

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Department Representative

Enc.

DE 1159P Rev. 10 (10-15) (INTRANET)

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UI / DE 1159P

REQUEST FOR COMPLETION OF CLAIM FORM AND/OR PARTIAL FORMS