EDD Assistance Request

My office is here to assist you and make sure your EDD experience goes as smoothly as it can. EDD’s processing time for submitted claims can be up to four weeks. If you have not gotten a response after four weeks of contacting EDD, please fill out the form below.

Please note that we are only able to assist constituents who live in Assembly District 18. If you are unsure who your state representative is, check here.

First Name *

Last Name *

Address *

City *

Zip Code *

Phone Number

Ext.

Phone Number Type

What did you apply for? *

What is your issue? *

Date Applied for Claims

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

Have you contacted another elected official? *

Yes

Detailed summary of your issue: *

REQUEST FOR ASSISTANCE AND AUTHORIZATION FOR RELEASE OF INFORMATION

By completing this form, I am requesting the Office of Assemblymember Bonta (the “Assemblymember”) to assist me in working with the Employment Development Department (EDD) on my claim. I acknowledge that this may require the release of information contained in my records the dissemination of which may be prohibited by law. Therefore, I hereby authorize EDD and the Assemblymember to share all relevant portions of my records with each other, and to discuss matters relating to those records and my claim, until my claim is resolved.

I agree that I will not submit any personal identifiable information through this form that is not specifically requested. If the Assemblymember's office needs additional information, such as my EDD number, the office will contact me to request that information. *

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