Contact Us You must have JavaScript enabled to use this form. Select a Contact Method Below Is this a Meeting or Event? Meeting Request | Event Request | Email Senator | EDD Assistance MEETING REQUEST Meeting Request CONTACT INFORMATION Name of Organization First Name M.I. Last Name Contact Email Contact Phone Address City State Zip Code PURPOSE OF MEETING Topic or Purpose of Meeting Bill Number Position? Support Oppose None Attach Supporting Documents (Upload up to 10 files) BROWSE FILE(s) Maximum 10 files.200 MB limit.Allowed types: jpeg, png, pdf, docx, pptx. Attendees Name Title Represents Attendee is a constituent Add Attendee List attendees State attendees name, title, who they represent, and if constituent DATE/TIME & LOCATION Meeting Date Meeting Time Dates and Times are Flexible Additional Dates and Time Preferred Location of Meeting Capitol Office San Diego Virtual Virtual Meeting Link (ex: Zoom, Microsoft Teams, etc.) Please provide link for this virtual meeting. Location Details If this is an IN PERSON request please include the address, city, state and zip code. Please include all names of attendees for this meeting & preferred location of meeting. Additional Comments Event_field Event Request CONTACT INFORMATION Name of Organization First Name M.I. Last Name Contact Email Contact Phone Address City State Zip Code EVENT LOGISTICS Event Date Event Time Date and Time are Flexible Additional Notes About the Dates or Times for Event Location Setting Indoors Outdoors Virtual Held Event Address City State Zip Code Virtual Meeting Link (ex: Zoom, Microsoft Teams, etc.) Please provide link for this virtual meeting. Location Details EVENT DETAILS Event Title Subject Matter to be addressed Please be concise. Dress Attire Business Casual Formal Senator's Role * Participate on Panel Remarks/Speech Present Resolution/Certificates Attendance only Other… Enter other… Additional Information about Senator's role Will Other Elected Officials be in Attendance? Yes No Are Press or Media invited to attend? Yes No Will There Be A Q&A? Yes No Number of Attendees Additional Information About Event EVENT FILES Attach Supporting Documents (Upload up to 10 files) BROWSE FILE(s) Info, Agendas, Flyers, etc. Maximum 10 files.200 MB limit.Allowed types: png, pdf, doc, docx, pptx. Email Field Email Senator Email Senator EDD_field EDD Assistance IMPORTANT* Before filling out the form below, please click the link to the right to make sure you are in the correct district. FIND MY REPRESENTATIVE Name Email Phone Address City Zip code Do you have an EDD Customer Account Number (CAN)? - Select -YesNo Last day of work Date case first filed Last Payment Date Describe the Issue What EDD program did you apply for? - Select -Unemployment Insurance (UI)Pandemic Unemployment Assistance (PUA)State Disability Insurance (SDI)Paid Family Leave (PFL)Workshare Type of Benefit (indicate which benefit you applied for) - Select -UnemploymentPUA (Pandemic Unemployment Assistance)PEUC (Pandemic Emergency Unemployment Compensation)FED-ED Extension (Federal-State Extended Duration)Not Sure Reason given by EDD for interruption of benefit payments - Select -ID VerificationSuspected/Potential FraudDisqualifiedWebsite issueNeed to reopen caseNo benefits leftOther or No Reason Given by EDD Issues with EDD - Select -Unable to Certify for BenefitsFile a new claim issueExtension PendingPayments Pending Leave this field blank
