Form De 8686 - Work Sharing (Ws) - Unemployment Insurance Plan Application Page 3
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5WORK SHARING EMPLOYER’S HOLIDAY SCHEDULE
This schedule is a required part of the Work Sharing Unemployment Insurance Plan Application
This information is necessary to process your employees’ Work Sharing (WS) payments. Work Sharing regulations
state that a holiday cannot be used as a WS day unless an employee in the same position performed compensated
services as part of an employee’s regular paid work week during the 12 months prior to the employer’s participation in
the WS Program.
Indicate whether your company was open or closed due to holidays on the days listed below during the 12 months prior
to the effective date of your WS Unemployment Insurance Plan Application. For example, if your WS Unemployment
Insurance Plan is effective in January 2003, the 12 month period would be January 2002 through December 2002.
HOLIDAY
OPEN
CLOSED
COMMENTS
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New Year’s Eve
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New Year’s Day
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Martin Luther King Jr. Day
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Lincoln’s Birthday
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Washington’s Birthday
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President’s Day
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Cesar Chavez
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Good Friday
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Memorial Day
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th
July 4
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Labor Day
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Columbus Day
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Veteran’s Day
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Thanksgiving
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Day After Thanksgiving
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Christmas Eve
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Christmas
Other Holidays: Please list below
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Please print or type the following information:
Date: ____/____/____
Employer Name:
California Employer Account Number (Eight Digits): ___ ___ ___ -- ___ ___ ___ ___ - ___
Contact Person:
Position or Title:
PAGE THREE OF FIVE
DE 8686 Rev. 14 (12-03) (INTERNET)
CU
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