UI / DE 120C

SAMPLE, this page for reference only.

The Great Seal of The State of California
Date:

Case #:

Dear:

This is in response to your telephone call/correspondence of
Blank line  

This office has taken the following action:

 
Department Representative
Centralized Overpayment Establishment Group
1-866-401-2849
PO Box 2228
Rancho Cordova, CA 95741-2228
DE 120C Rev. 6 (2-18) (INTERNET)