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UI / DE 6316DUA
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SAMPLE
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EDD Telephone Numbers:
English:
1-800-300-5616
Spanish:
1-800-326-8937
Cantonese:
1-800-547-3506
Mandarin:
1-866-303-0706
Vietnamese:
1-800-547-2058
TTY (non-voice):
1-800-815-9387
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Date
MM/DD/YYYY
NOTICE REGARDING BENEFITS PAID PENDING VERIFICATION OF EMPLOYMENT
Name
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For Office Use Only
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Pursuant to 20 Code of Federal Regulations
625.6(e)(1)
, you have twenty-one (21) days from
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- -
to submit documentation to substantiate that you were employed or self-employed prior to becoming unemployed as a direct result of the disaster, or were scheduled to commence employment or self-employment on or after the date the disaster began. Acceptable documentation includes, but is not limited to: Business license, resale license, contract for services, employer letter
.
Failure to submit documentation to substantiate that you were employed or self-employed prior to becoming unemployed as a direct result of the disaster, or were scheduled to commence employment or self-employment on or after the date the disaster began, will result in disqualification from Disaster Unemployment Assistance (DUA) benefits under 20 Code of Federal Regulations
625.6(e)(2)
. An overpayment will be established under 20 Code of Federal Regulations
625.14(a)
, to recover any benefits paid. Under 20 Code of Federal Regulations
625.14(i)
, fraud will also be considered.
DE 6316DUA Rev. 4 (10-21)
(INTRANET)
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