Form DE4809 "Prior Wages Notice Correction/Update Request" - California

What Is Form DE4809?

This is a legal form that was released by the California Employment Development Department - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2015;
  • The latest edition provided by the California Employment Development Department;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form DE4809 by clicking the link below or browse more documents and templates provided by the California Employment Development Department.

ADVERTISEMENT
ADVERTISEMENT

Download Form DE4809 "Prior Wages Notice Correction/Update Request" - California

Download PDF

Fill PDF online

Rate (4.7 / 5) 35 votes
PRIOR WAGES NOTICE CORRECTION/UPDATE REQUEST
1. California Employer Account Number:
(8 Digit Code)
2. Business Name:
3. Other Business Names:
4. Mailing Address:
(Address)
(City)
(State)
(Zip Code)
5. Phone Number: (
)
(Area Code)
(Phone Number)
6. Prior Wages Notice Number :
7. Date of Prior Wages Notice:
Complete Section A if you are reporting a correction required on a current Wages Notice.
Complete Section B if you need to update a prior Wages Notice to reflect a more recent layoff.
Section A: Wages Notice Correction
8. Please explain what corrections are necessary to the Wages Notice.
Section B: Wages Notice Update
9. Please provide the following information regarding the current layoff:
Date(s) of Layoff
Number of California
Location(s) of Affected Job Sites
Employees Laid Off
in California
(MM/DD/YY–MM/DD/YY)
(City)
DE 4809 Rev. 5 (11-15) (INTERNET)
Page 1 of 4
CU
PRIOR WAGES NOTICE CORRECTION/UPDATE REQUEST
1. California Employer Account Number:
(8 Digit Code)
2. Business Name:
3. Other Business Names:
4. Mailing Address:
(Address)
(City)
(State)
(Zip Code)
5. Phone Number: (
)
(Area Code)
(Phone Number)
6. Prior Wages Notice Number :
7. Date of Prior Wages Notice:
Complete Section A if you are reporting a correction required on a current Wages Notice.
Complete Section B if you need to update a prior Wages Notice to reflect a more recent layoff.
Section A: Wages Notice Correction
8. Please explain what corrections are necessary to the Wages Notice.
Section B: Wages Notice Update
9. Please provide the following information regarding the current layoff:
Date(s) of Layoff
Number of California
Location(s) of Affected Job Sites
Employees Laid Off
in California
(MM/DD/YY–MM/DD/YY)
(City)
DE 4809 Rev. 5 (11-15) (INTERNET)
Page 1 of 4
CU
10. Will employees affected by the current layoff receive the same payments under the same company
policy described in the prior Wages Notice?
Yes
No
If no, please explain the policy and/or payments.
11. Please provide the following information regarding payments which will be paid to employees affected
by the current layoff:
Type of Payment
Period Covered by
Work Group Eligible to Receive
Payment (if applicable)
Payment
(MM/DD/YY–MM/DD/YY)
12. Comments:
Employer Representative/Agent:
Name:
Title:
Phone Number: (
)
(Area Code)
(Phone Number)
Mailing Address (if different than the business address):
DE 4809 Rev. 5 (11-15) (INTERNET)
Page 2 of 4
CU
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 (UI) 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 UI 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: 02/05/14 – 06/30/14
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. 5 (11-15) (INTERNET)
Page 3 of 4
CU
10. If there are any additional payments not addressed in the prior Wages Notice, describe the different
payments, basis for payments, eligibility requirements, etc.
11. List the payments, other than wages through the last day worked and accrued vacation, that
employees affected by the current layoff will receive.
TYPE OF PAYMENT – Enter what the company calls the payment.
PERIOD COVERED BY PAYMENT – If the payment covers a specific period of time, enter the
dates. For example, if you are reporting in-lieu-of-notice pay you would enter the date through
which employees are in receipt of in-lieu-of notice pay.
WORK GROUP ELIGIBLE TO RECEIVE PAYMENT – Enter the work group that will receive the
payment if it is only a specific group of employees, e.g., assembly line workers, hourly employees,
represented employees, etc. If the layoff involves several sites and only employees at some sites
will receive the pay, you may enter site location under Work Group. If all employees affected by the
layoff will receive the payment, no entry is required.
12. COMMENTS
Provide any additional information regarding the payments that you feel is important
and can assist the Department in determining if the payments will affect the employees’ eligibility for
UI benefits.
For more information about completing this form, please call (916) 403-6358 and ask to speak to a
representative in the Wages Notice Group.
You may FAX the completed form to (916) 449-2192, or mail to Employment Development Department,
UI Integrity and Accounting Division, MIC 16A, Wages Notice Group, P.O. Box 2228, Rancho Cordova,
CA 95741-2228.
DE 4809 Rev. 5 (11-15) (INTERNET)
Page 4 of 4
CU