DE 1430 Form PDF Details

The California Unemployment Insurance Appeals Board (CUIAB) plays a crucial role in providing individuals and employers an avenue to contest decisions made by Administrative Law Judges (ALJs) regarding unemployment, tax, or disability cases. Central to this appeals process is the DE 1430 form, a formal document that must be submitted within a set timeline—specifically, within 30 calendar days from the date the ALJ's decision is stamped and mailed. This form serves as a vital tool for appellants, be they claimants, employers, or even the Employment Development Department (EDD) itself, aiming to challenge an ALJ's unfavorable decision. It requires detailed information about the appellant, including contact details and specifics surrounding the appeal such as the ALJ's decision date and case number. Furthermore, it opens the possibility for the appellant to continue claiming benefits while the appeal is under consideration, although it comes with the caution that any benefits received during this period may need to be repaid if the appeal does not result in a favorable outcome. The DE 1430 form also accommodates those seeking to present new or additional evidence, underscoring the importance of thoroughness and accuracy in the appeals process. This document not only highlights the procedural details required for a successful appeal but also emphasizes the rights of individuals and entities to seek justice and correct potentially flawed decisions impacting their unemployment, tax, or disability claims. Understanding the DE 1430 form and the procedures it entails is essential for anyone navigating the complexities of the CUIAB appeals process.

QuestionAnswer
Form Name DE 1430 Form
Form Length 2 pages
Fillable? No
Fillable fields 0
Avg. time to fill out 30 sec
Other names DE_1430_Fill in how to fill out cuiab board appeal form, cuiab board appeal

Form Preview Example

CUIAB – BOARD APPEAL

If you disagree with the unfavorable CUIAB Administrative Law Judge’s (ALJ) decision in your unemployment, tax or disability case, you must file your Board Appeal within 30 calendar days from the mailing date stamped on the front of the ALJ’s decision.

Claimant: You must continue to file claim forms during the time we are deciding your appeal if you wish to claim benefits for this period of time. If you are found ineligible for these benefits, however, you may be required to repay benefits received. Please direct all claim questions to the Employment Development Department (EDD) at: http://www.edd.ca.gov.

The following information must be provided by the party filing the appeal (Appellant) or authorized agent/representative.

Check party filing the appeal: Claimant Employer EDD

Appellant Name:

 

 

ALJ Decision Date and Case No.:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Appellant Phone No.: (_______)

-

 

 

Appellant Fax No.: (_______)

-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Appellant Mailing Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street No., Apt. No., P.O. Box

 

 

 

City

 

 

 

State

 

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Do you give permission for the CUIAB to send confidential information regarding your appeal to your e-mail address and/or cell phone

by voice or text message (Information may be received sooner)? Yes

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

If

yes, please provide the e-mail address and/or cell phone number where you would like the information sent.

 

 

E

-mail Address:

Cell Phone No.: (_______)

-

 

 

 

 

 

 

 

 

 

 

 

Claimant Name:

Social Security No.:

 

–

 

–

Employer Account No.: (For Employer Only)

Appellant Agent or Representative Name (If applicable):

Mailing Address:

 

 

 

Street No., Apt. No., P.O. Box

City

State

Zip Code

Check box if you are not filing your appeal on time (within 30 days from the date listed on the front of the ALJ’s decision) and provide explicit details on reasons for the delay.

Check box if presenting new or additional evidence. Attach documents and explain why they were not presented at the hearing.

I disagree with the Administrative Law Judge’s decision because:

(If you need additional space please use the lines on the back of this page)

Signature of the Appellant or

 

 

 

Agent / Representative Required:

 

Date:

 

 

 

 

DE 1430 Rev. 3 (3-18)

- Español al reverso -

 

CU

CUIAB-APELACIÓN A LA JUNTA

Si usted no está de acuerdo con la decisión desfavorable del Juez de Justicia Administrativa (ALJ, por sus siglas en inglés) de la Junta de Apelaciones

del Seguro de Desempleo de California (CUIAB, por sus siglas en inglés), referente a su caso de desempleo, impuestos o de incapacidad, usted debe Apelar a la Junta dentro de 30 días de calendario de la fecha indicada en el frente de la decisión del Juez.

Solicitante: Usted debe continuar presentando sus formularios de solicitud de beneficios mientras decidimos su apelación si desea recibir beneficios durante este período de tiempo. Si decidimos que usted no es elegible para recibir estos beneficios, es posible que a usted se le requiera pagar los beneficios que recibió. Por favor dirija todas sus preguntas referente a la solicitud de beneficios a la oficina del Departamento del Desarrollo del Empleo en: http://www.edd.ca.gov.

La siguiente información debe ser proporcionada por la parte que presenta la apelación (el Apelante) o por el agente/representante autorizado.

Marque la parte que presenta la apelación: Solicitante Empleador Departamento del Desarrollo del Empleo

Nombre del Apelante:

 

 

Fecha de la Decisión del Juez y Número de Caso:

 

 

 

 

 

 

 

 

 

Número de Teléfono del Apelante :(_______)

-

 

Número de Fax del Apelante: (_______)

-

 

 

 

 

Dirección Postal del Apelante:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Número de Calle, Número de Apto. P.O. Box

 

Ciudad

 

Estado Código Postal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

¿Da usted permiso para que la Junta de Apelaciones del Seguro de Desempleo de California le mande información confidencial relacionada a su apelación a la dirección de su correo electrónico y/o teléfono celular vía mensaje de voz o de texto (La información puede ser enviada más

rápida)? Sí No

Si contestó sí, favor de proporcionar su correo electrónico y/o número de teléfono celular a donde usted desee que se le envíe la información.

Dirección de Correo Electrónico:

 

Número de Teléfono Celular: (_______)

-

 

 

 

 

 

Nombre del Solicitante:

Número de Seguro Social:

 

–

 

–

 

 

 

 

 

 

 

Número de Cuenta del Empleador: (Sólo para Empleadores)

Nombre del Agente del Apelante o del Representante (Si aplica):

Dirección Postal:

 

Número de Calle, Número de Apto. P.O. Box

Ciudad

Estado Código Postal

 

 

 

 

 

 

Marque la casilla si usted no está presentando su apelación a tiempo (dentro de 30 días de la fecha indicada en el frente de la decisión del Juez) y explique con detalles específicos la razón por la tardanza.

Marque la casilla si usted está pidiendo presentar evidencia nueva o adicional. Adjunte los documentos y explique por qué no fueron presentadas en la audiencia.

No estoy de acuerdo con la decisión del Juez de Justicia Administrativa porque:

(Si necesita espacio adicional por favor use el lado reverso de esta página)

La Firma del Apelante o del

 

Agente/Representante es Requerida:

Fecha:

DE 1430 Rev. 3 (3-18)

- English version on other side -

MIC38/CU

How to Edit DE 1430 Form Online for Free

DE 1430 Form can be filled out online without any problem. Simply open FormsPal PDF editor to do the job right away. In order to make our tool better and more convenient to work with, we constantly design new features, bearing in mind suggestions coming from our users. In case you are seeking to get going, here's what you will need to do:

Step 1: Hit the "Get Form" button above. It is going to open our editor so you can start filling out your form.

Step 2: With this online PDF editor, you can do more than simply fill in blank fields. Edit away and make your docs seem professional with customized text added, or modify the file's original content to excellence - all that backed up by an ability to insert your own images and sign the PDF off.

This document requires particular data to be filled out, therefore you should definitely take the time to provide precisely what is expected:

1. Begin filling out your DE 1430 Form with a group of major fields. Gather all of the important information and make certain absolutely nothing is omitted!

Learn how to complete De 1430 Form portion 1

2. The subsequent stage is to complete the next few blank fields: Check box if presenting new or, and I disagree with the Administrative.

How to fill in De 1430 Form portion 2

3. The next stage is usually simple - fill out all the blanks in Signature of the Appellant or, Date, If you need additional space, DE Rev, and Español al reverso to finish the current step.

Stage no. 3 for completing De 1430 Form

When it comes to Español al reverso and Signature of the Appellant or, ensure that you double-check them here. The two of these are the most important fields in the PDF.

4. It's time to complete this next section! Here you will get these La siguiente información debe ser, Departamento del Desarrollo del, Empleador, Nombre del Apelante, Fecha de la Decisión del Juez y, Número de Teléfono del Apelante, Número de Fax del Apelante, Dirección Postal del Apelante, Número de Calle Número de Apto PO, Ciudad, Estado Código Postal, Da usted permiso para que la Junta, Si contestó sí favor de, Dirección de Correo Electrónico, and Número de Teléfono Celular form blanks to complete.

The way to fill in De 1430 Form step 4

5. The last point to finalize this document is critical. Make certain to fill in the appropriate blanks, which includes Marque la casilla si usted está, No estoy de acuerdo con la, and Si necesita espacio adicional por, before finalizing. If you don't, it could lead to a flawed and possibly unacceptable document!

Completing segment 5 in De 1430 Form

Step 3: Check that the details are correct and then simply click "Done" to complete the task. After setting up a7-day free trial account with us, it will be possible to download DE 1430 Form or send it via email promptly. The file will also be readily available from your personal cabinet with all your changes. Here at FormsPal.com, we do everything we can to be sure that all your information is stored secure.

DE 1430 Form isn’t the one you’re looking for?

Related Documents