DI / DE 2530A

SAMPLE, this page for reference only.

EDD Employment Development Department State of California Logo

Instructions for Authorized Representatives and Heirs

 
Mailing Date
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Claimant Name
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CED
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Office No.
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Blank Box
 

 

The Employment Development Department (EDD) received and processed the document you provided that designates you as an authorized representative or heir of the above-named claimant. You are receiving these instructions for the sole purpose of claiming Disability Insurance (DI) or Paid Family Leave (PFL) benefits on behalf of the above-named claimant or his/her estate. A copy of the declaration you returned to the EDD is enclosed.
  • This document: Instructions for Authorized Representatives and Heirs (DE 2530A.)
  • Your valid photo identification.
  • The claimant's Electronic Benefit Payment (EBP) Debit Card.
  • A copy of the document you provided to the EDD that appoints you as the claimant’s Authorized Representative.
     
    NOTE:
    An authorized representative will need to know the balance on the EBP card before requesting a withdrawal.
  • Your valid photo identification and contact information (phone number).
  • A copy of the certified death certificate.
  • The Affidavit/Declaration for Collection of Decedent’s Deposit Account(s) and/or Safe Deposit Box Contents (provided and notarized by Bank of America).
     
    Return these documents to Bank of America by:
To locate a Bank of America branch, visit bankofamerica.com.
For authorized representative or heir cardholder issues, please call Bank of America Enterprise Estate Servicing Operations at ‎1-855-893-8793. For general EBP Debit card questions, please call Bank of America customer service at
‎ 1-866-692-9374
(voice) or
‎1-866-656-5913
 ( TTY (non-voice) ).

DE 2530A Rev. 6 (4-21) (INTRANET)