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Uncashed benefit payment check or unclaimed electronic benefit payment claim form 2026
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How to use or fill out uncashed benefit payment check or unclaimed electronic benefit payment claim form
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- Click ‘Get Form’ to open it in the editor.
- Begin with the Claimant Information section. Fill in your last name, first name, middle initial, address, Social Security number, city, state, ZIP code, and phone number.
- If you are filing on behalf of someone else, complete the Attorney or Representative Information section with their details including relationship to the claimant.
- In the Claim Information section, specify the type of payment (Unemployment Insurance, Disability Insurance, or Paid Family Leave) and indicate if your claim is for a stale-dated check.
- Provide the exact name on the check and its dollar amount. If you have the original check, indicate this and attach copies of both sides.
- Complete any additional questions regarding EDD Debit CardSM activation and notices from Bank of America.
- Finally, read the declaration statement carefully before signing and dating the form at the bottom.
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