UI / DE 8598

SAMPLE, this page for reference only

 

NOTICE OF ADJUSTMENT OF DISASTER UNEMPLOYMENT ASSISTANCE (DUA) WAGES/EARNINGS

  1. Name:Blank Space
  2. Address:Blank Space
  1. For Office Use OnlyBlank Space
  2. BYBBlank Space
  3. FEMA #Blank Space
Quarter
Ended
Wages
Requested
Amount
Allowed
Quarter
Ended
Wages
Requested
Amount
Allowed
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7. Blank Space  Blank Space  9. Blank Space  Blank Space 
10. REASON:
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DATE OF MAILING
 
PROTEST OR APPEAL RIGHTS
You may obtain assistance in protesting or filing an appeal by calling the EDD office listed in the white pages of the telephone directory.
DE 8598 Rev. 1 (12-21) (INTRANET)