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WILDFIRES 2020: New information and resources updated on my dedicated page.

Assemblymember Jim Frazier

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EDD Request Form

1 Start 2 Complete

Select your zip code

Contact Information

First Name *

Last Name *

Street Address *

City *

Zip Code *

Phone Number *

Email Address *

EDD Information

Date your unemployment claim was filed *

Month

Day

Year

What EDD program did you apply for? *

Unemployment Insurance (UI)

Pandemic Unemployment Assistance (PUA)

State Disability Insurance (SDI)

Paid Family Leave (PFL)

What is your issue with EDD? *

ID Verification

Wage Verification

Appeals

Unpaid Benefits

Pandemic Unemployment Assistance

Other

If "other", please describe your issue in a few words:

Have you certified for ALL weeks pending of benefits? *

Yes

No

How many weeks of benefits are you owed? (Please answer as accurately as possible) *

When was the last time you received a correspondence from EDD (via mail, phone, or text) *

Month

Day

Year

Have you contacted another elected offical? *

Yes

No

If yes, who have you contacted?

Summary of Issue: *

Disclaimer: *

Please do not send any personal identifiable information through this form that is not specifically requested. If we need additional information, such as your EDD number, we will contact you to request that information.

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Resources

https://a11.asmdc.org/sb1-transportation-projects-assembly-district-11

article/veterans-resources

https://a11.asmdc.org/article/special-driver%E2%80%99s-licenses-and-identification-cards-help-veterans-gain-access-benefits

article/it-can-wait-0

article/unclaimed-property-0

https://www.coveredca.com/

article/california-state-parks-0

https://www.csac.ca.gov/

article/aquatic-invasive-species-0

article/education-resources-0

article/resources-job-seekers-0

article/small-business-resources-0

/internship-application-0

Contact

Capitol Office:
State Capitol
P.O. Box 942849
Sacramento, CA 94249-0011
Tel: (916) 319-2011
Fax: (916) 319-2111

District Office:
1261 Travis Blvd., Ste. 110
Fairfield, CA 94533
Tel: (707) 399-3011
Fax: (707) 399-3030

District Office:
150 City Park Way
(Brentwood City Hall)
Brentwood, CA 94513-1164
Tel: (925) 513-0411
Fax: (925) 513-3511

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