California Employment Information Form
Description
How to fill out Employment Information Form?
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FAQ
Getting the form from your physician/practitioner or employer. Visiting an SDI Office. Calling 1-800-480-3287 to request a paper form by mail.
Step 1: Get Your Claim FormOrdering a form online to have it mailed to you.Getting the form from your physician/practitioner or employer.Visiting an SDI Office.Calling 1-800-480-3287 to request a paper form by mail.
Employers can print and complete the Internet version for submission to EDD. The Traditional Chinese version is a sample and is to be used as a guide when completing the English version. Review the DE 4209, Completion Instructions for Notice of Reduced Earnings for more information on partial claims.
Recommended: Log in to your UI Online account and go to the Upload Income Documents for PUA section on the homepage to provide the required documents. If you prefer to mail your documents, write your 10-digit EDD Customer Account Number (EDDCAN) clearly at the top of each page.
mail. Send an email to WOTCsupport@edd.ca.gov. Important Security Reminder: For your protection, if you are sending us an email through third party email software (e.g., Yahoo, Gmail, Outlook), please do not include confidential information such as account numbers, passwords, or Social Security numbers.
Claim for Disability Insurance (DI) Benefits (DE 2501) English: You must submit an original form provided by the EDD, either electronically or through US mail. It cannot be downloaded or reproduced.
Employers can print and complete the Internet version for submission to EDD. The Traditional Chinese version is a sample and is to be used as a guide when completing the English version.
