WAGES NOTICE REQUEST ­ HOLIDAY/VACATION PAY (WORK SHARING AND NON-WORK SHARING EMPLOYER) 1. California Employer Account Number: ___________________________________________________ 2. Business Name: ____________________________________________________________________ 3. Other Business Names: ______________________________________________________________ 4. Mailing Address: ____________________________________________________________________ __________________________________________________________________________________ (City) (State) (Zip Code) (Address) (8 Digit Code) 5. Union Name, Local, and Phone Number (if applicable): ______________________________________ 6. Prior Wages Notice Number (if applicable): _______________________________________________ 7. Will employees have a definite date to return to work following the holiday shutdown/layoff? ____ All employees will have a definite date to return to work. ____ Some employees will have a definite date to return to work, other employees will not. ____ None of the employees will have a definite date to return to work. If NONE of your employees will have a definite date to return to work, please proceed to item 14. 8. If any of your employees who have a definite date to return to work, please provide the following: Last Date Worked (MM/DD/YY) Return to Work Date (MM/DD/YY) Affected Work Group 9. For what date(s) will the company pay holiday pay? Also, please indicate the date the payment will be made to the employees. If the company has different payroll periods for different groups of employees or classifications, please specify the group or classification and payroll period for the group. Date of Paid Holiday (MM/DD/YY) Payment Date (MM/DD/YY) Payroll Group (If different payroll periods.) DE 4806 Rev. 6 (11-15) (INTERNET) Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com CU 10. Are the affected employees required to use vacation pay during the shutdown/layoff period? ____Yes ____No 11. May the affected employees request vacation pay during the shutdown/layoff period? ____Yes ____No 12. Does the employer allow a vacation advance if an employee does not have any accrued vacation? ____Yes ____No If YES, please explain company policy with respect to vacation advances: _______________________ __________________________________________________________________________________ __________________________________________________________________________________ 13. Are any of your employees participating in the Work Sharing Unemployment Insurance Program? ____Yes ____No If YES, please provide the following information: Did/will any of the Work Sharing employees work reduced hours during the holiday shutdown/layoff? ____Yes ____No If YES, please indicate the number of employees in this category ____. Did/will any of the Work Sharing employees not work at all during the holiday shutdown/layoff? ____Yes ____No If YES, please indicate the number of employees in this category ____. 14. If any of your employees do not have a definite date to return to work, please provide the following information (if you have different layoff periods list them separately): Date(s) of Layoff (MM/DD/YY­MM/DD/YY) Number of California Employees Laid Off Location(s) of Affected Job Sites in California (City) 15. Additional Information: _______________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ Employer Representative/Agent: Name: ___________________________________________ Date: ______________________________ Title: ____________________________________ Phone Number: (_____) ________________________ (Area Code) (Phone Number) Mailing Address (if different than the business address): ________________________________________ ________________________________________ ________________________________________ DE 4806 Rev. 6 (11-15) (INTERNET) Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com CU INSTRUCTIONS FOR WAGES NOTICE REQUEST - HOLIDAY/VACATION PAY (WORK SHARING AND NON-WORK SHARING EMPLOYERS) 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 claimants. The Wages Notice will provide Department staff with general information regarding the holiday/vacation payments and a determination of whether the payments will affect the claimants' eligibility for unemployment insurance benefits. The Department will 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. If affected employees are covered by a collective bargaining agreement, please provide the union name, local number and phone number. 6. If we have issued a Wages Notice for your company in the past, please provide the prior Wages Notice number, if available. 7. Indicate if employees will have a definite date to return to work. In other words, when the employees left work were they scheduled to return to work on a specific date? If employees are given an approximate return-to-work date or are told to check back on a certain date to see if they are to report to work, that is not considered a definite date to return to work. In this case, the layoff is for an indefinite period. An indefinite layoff severs the employer-employee relationship. Vacation pay and holiday pay which are paid upon the termination of the employment relationship are not wages for unemployment insurance purposes and do not affect an individual's eligibility to receive benefits. In this case a Wages Notice is not necessary and will not be issued. 8. Complete this item if any of your employees will receive a definite date to return to work. LAST DATE WORKED ­ Enter the last date the employees worked prior to the shutdown/layoff. RETURN TO WORK DATE ­ Enter the date the employees are scheduled to return to work. AFFECTED WORK GROUP ­