Form DE 1181 at a glance
What it is: Form DE 1181 is the Authorization for Release of Unemployment Insurance Records for Retired Annuitant.
Who signs: Sign on the Retired Annuitant Signature line, then enter the Social Security Number: XXX-XX- and the Date of Appointment.
Where and when to file: To: Employment Development Department, Orange County Primary Call Center, P.O. Box 5007, Buena Park, CA 90622.
The retired annuitant authorizes the Employment Development Department (EDD) to release the Unemployment Insurance (UI) information for purposes related to Government Code section 21224 [Retired Annuitant (RA) return to work prohibition for a CalPERS employer if UI benefits collected within the last 12 months].
What to bring and attach to Form DE 1181
The appointing entity must include a stamped self-addressed return envelope with each request.
A filled-in Form DE 1181 example: a retired annuitant signs the authorization
How to fill out Form DE 1181, box by box
Your name
Print your name after I.
State Agency and Mailing Address
Under TO: the appointing entity, enter the Name and Title, the State Agency, the Mailing Address, and the City, State, and ZIP Code.
Signing, the date and the appointment
Enter the Date as month/day/year. This Authorization shall remain in effect for 12 months from the date signed.
Sign on the Retired Annuitant Signature line, then enter the Social Security Number: XXX-XX- and the Date of Appointment.
Failure to sign this consent does not preclude the appointing entity authority from obtaining this information from the EDD after you are hired, pursuant to California Unemployment Insurance Code section 322.
RA Declined to Sign Consent Authorization
If the RA declined to sign, the Appointing Agency Representative marks RA Declined to Sign Consent Authorization, then signs the Appointing Agency Representative Signature and enters the Print Name.
Common questions about Form DE 1181
Where do I file it?
To: Employment Development Department, Orange County Primary Call Center, P.O. Box 5007, Buena Park, CA 90622.
Sources
[1] Form DE 1181 (7-21), Authorization for Release of Unemployment Insurance Records for Retired Annuitant, Employment Development Department (the Official source link on this page).