SAMPLE, this page for reference only

UI Payment Abstract

In response to your request regarding Form 1099G, Report of Taxable Unemployment Compensation Payments, we are providing a summary of all Unemployment Compensation (UC) benefits issued to you during the calendar year.

The UC total includes Unemployment Insurance (UI) benefits, Paid Family Leave (PFL) Insurance benefits and Disability Insurance (DI) benefits paid as a substitute for UI benefits. DI benefits are considered a substitute for UI benefits when an individual is ineligible for Ul as a result of a disability. These benefits are taxable and reported as UC in accordance with Federal Tax Regulations Section ‎1.85-1. The PFL Insurance benefits are taxable and reportable in accordance with Sections 61 and 85 of the Internal Revenue Code.

Please note the week ending dates may not all be for the current calendar year. A directive from the U.S. Department of Labor states Form 1099G includes all benefits actually issued within the calendar year even though some benefits were for weeks ending in the prior year.

When reviewing the attached payment listing, please note that a payment with a week ending labeled "SPLIT-PMT” will be reported in two separate claims. The payment number and issue date will be the same. However, the total amount of the payment will be divided between the two claims.

If you did not receive the payment(s) listed, and would like a copy of the check(s), or a listing of debit card payments, whichever is applicable, CIRCLE the payment(s) you did not receive and return this letter to:

If you have any questions, please contact the Employment Development Department 1099G representative at ‎866-401-2849.

DE 1099A Rev. 5 (4-18) (INTRANET)