DI / DE 2514-20

SAMPLE, this page for reference only

EDD - PAID FAMILY LEAVE
PO BOX 997017
SACRAMENTO CA 95899-7017
SAMPLE CLIENT
‎1234 ANY STREET
ANY CITY
 

Notice of Denied Paid Family Leave (PFL) Benefits ‑ Not Working, Seasonal Employment

Mailing Date:
MM/DD/YY
Claim Effective Date:
MM/DD/YY

We are unable to pay you Paid Family Leave (PFL) benefits from MM/DD/YY through MM/DD/YY because:

You are requesting benefits for a period outside of your normal contractual employment period. You must be working or looking for work when the need for family care arises. The period for which you are requesting benefits to provide care is outside of your normal employment contract.
Basis:
California Unemployment Insurance Code (CUIC), section 140.5

This determination is final unless you send a written appeal within thirty days from the mailing date above. You may appeal by completing the enclosed Appeal Form or separately writing a detailed statement of why you believe the determination is in error. Please include your Social Security number on your appeal and send it to the EDD office shown above.

Notice of Determination

DE 2514-20 Rev. 2 (03-18) (INTRANET)