Regulations Covering the Discharge of Any Employee

• Name of Employer
• Name of Employee
• Type of Action: discharged, layoff, leave of absence, suspension or change of employment status
• Social Security Number of the Employee
• Date of the Action

We recommend you prepare the employee notice in duplicate and place the second copy in the employee’s personnel file.

You must also at the time the Notice is given to the employee, give him/her pamphlets explaining benefit rights to employees if they become unemployed or are ill, injured, or hospitalized due to causes not related to work. These pamphlets must be given to each new employee and to each employee who leaves your employment. Both pamphlets are available in Spanish version. The pamphlets are:

• "For Your Benefit - California’s Programs for the Unemployed" (DE 2320)
• "State Disability Insurance Provisions" (DE 2515)

Employers who fail to provide the required notice or provide the required pamphlets may be liable for civil penalties up to $500 for each day of violation, and up to 60 days back pay and benefits to affected employees.

Here is a sample form you can use. We have titled it "Notice To Employee As To Change In Relationship". Please feel free to reproduce this for your compliance needs. You may obtain the necessary pamphlet publications by calling (916) 322-2835, EDD’s 24 hour automated call system, or fax your order to (916) 327-9171. Please indicate the quantity requested on the line preceding the form number if you fax your order in.

Should you have any questions or concerns regarding EDD’s policies, feel free to call Arnold Schwarzenegger at (916) 445-2841 to discuss the issue.

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Notice To Employee As To Change In Relationship

(Issued pursuant to provisions of Section 1089 of the California Unemployment Insurance Code.)

Company Name Address _____________________________________

Telephone (      ) _________________

Employee Name SS#_________________________________________

Type of Action:______________________________________________

(discharged, layoff, leave of absence, suspension, type of change)

You were laid off/discharged on _______________________2003

By Title___________________________________________________

Employee Signature _________________________________________