UI / DE 1480Z (Coupon)

SAMPLE, this page for reference only.

EDD Employment Development Department State of California Logo

NOTICE OF DENIAL OF BENEFITS AND OVERPAYMENT

INTEGRITY AND ACCOUNTING DIVISION
PHONE: ‎1-866-401-2849
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Print your Case Number on all Checks and Money Orders
Make Checks or Money Orders Payable to EDD and Send to:
EMPLOYMENT DEVELOPMENT DEPARTMENT
ATTENTION: CASHIER BENEFIT RECOVERY
PO BOX 826806
SACRAMENTO CA 94206-001
Please do not send cash through the mail
Detach and Return This Portion with Payment
TEAR ON PERFORATED LINE

To appeal this determination: Mail correspondence and any supporting documentation in a separate envelope to:

Employment Development Department Centralized Overpayment PO Box 980105 West Sacramento CA 95798-0105

(Include your Social Security Number on all correspondence.)

KEEP THIS PORTION FOR YOUR RECORDS

To make payment: Detach coupon and mail with your check or money order in the enclosed envelope to:

Employment Development Department Attention: Cashier Benefit Recovery PO Box 826806 Sacramento CA 94206-001

For credit card payments: Accepted credit cards are: Visa, Discover/Novus, American Express or Mastercard. Visit acipayonline.com or Call: ‎1-888-272-9829 . Enter 1577 for the jurisdiction code.

For assistance with your transaction, call ‎ 1-800-487-4567 Monday through Friday, 9 a.m. to 5 p.m., Pacific Time.

NOTE: When using the credit card option, you will be assessed a service fee (paid directly to ACI Payments, Inc). Your payment will post to your credit card account on the date you charged it, but it may not post to your EDD account for 3-5 days. If you pay your benefit overpayment by credit card and subsequently reverse the credit card transaction, you may be subject to interest and other fees imposed by EDD for nonpayment or late payment.

DE 1480Z Rev. 5 (12-21) Coupon (INTRANET)