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Form DE1378DI "Application for Disability Insurance Elective Coverage 2025

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The document is an application for Disability Insurance Elective Coverage (DIEC) under the California Unemployment Insurance Code. It outlines eligibility requirements, conditions for denial of coverage, and necessary information for self-employed individuals or partners seeking to elect coverage. The application requires details about the applicant's business, income, and any previous claims or disabilities. It also explains the process for approval, premium payments, and cancellation of coverage.

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