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EDD Assistance Form
Select your zip code
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Contact Information
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Do you have an EDD Customer Account Number (CAN)? *
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Yes
No
CAN #(Make sure to include your CAN number provided by EDD) *
Date of Birth *
Date case first filed *
Last day of work *
Date of last payment *
Describe the Issue *
Type of Benefit (indicate which benefit you applied for) *
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Unemployment
PUA (Pandemic Unemployment Assistance)
PEUC (Pandemic Emergency Unemployment Compensation)
Reason given by EDD for interruption of benefit payments *
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ID Verification
Suspected/Potential Fraud
Disqualified
Website issue
Need to reopen case
No benefits left
Other or no reason given by EDD
Leave this field blank
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