Instructions For Prior Wages Notice Update/correction Request (Form De 4809) printable pdf download

Instructions For Prior Wages Notice Update/correction Request (Form De 4809)

INSTRUCTIONS FOR PRIOR WAGES NOTICE UPDATE/CORRECTION REQUEST

The Employment Development Department will prepare a Wages Notice based on the information you

provide. The Department issues a Wages Notice to reduce the number of calls to employers and to

promote consistent decisions from Department staff regarding payments received by unemployment

insurance claimants. The Wages Notice will provide Department staff with general information regarding

the post-employment payments and a determination of whether the payments will affect the claimants’

eligibility for unemployment insurance benefits.

The Department will also mail you a copy of the Wages Notice for your records.

Please follow the instructions carefully:

1. CALIFORNIA EMPLOYER ACCOUNT NUMBER - Enter your California state employer account number.

2. BUSINESS NAME – Enter the name by which your business is known.

3. OTHER BUSINESS NAMES – Enter other names by which your business is known and which your

employees may report as their employer.

4. MAILING ADDRESS – Provide business mailing address.

5. PHONE NUMBER – Enter business phone number including area code.

6. Enter the number of the Wages Notice that you would like us to correct or update.

7. Enter the issue date of the Wages Notice that you would like us to correct or update.

Section A: Wages Notice Correction

Complete this section if you would like to report information you feel needs to be added or corrected on

a current Wages Notice.

8. Provide specific information regarding the required changes. If appropriate, be sure to include any

pertinent dates, eligibility requirements, payment type, amounts, etc.

Section B: Wages Notice Update

Complete this section if you are providing information on a more recent layoff and would like us to

update a prior Wages Notice.

9. If you have different layoff periods list them separately.

DATE(S) OF LAYOFF – Enter the date(s) you laid off or plan to lay off the employees. If layoffs will

occur over a period of time and you do not have specific dates, you may indicate anticipated beginning

and ending dates. Example: 02/05/99 – 06/30/99

NUMBER OF CALIFORNIA EMPLOYEES LAID OFF – Enter the total number of employees who work

in California and who will be laid off during the period indicated.

LOCATION(S) OF AFFECTED JOB SITES IN CALIFORNIA – Enter the name(s) of the California

city/cities where the job site(s) affected by the layoff is (are) located. If several job sites throughout

California are affected you may indicate “statewide” rather then listing the individual job sites.

DE 4809 Rev. 2 (12-02) (INTERNET)

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Instructions For Prior Wages Notice Update/correction Request (Form De 4809)