CA-EE-HBK

HOURLY RESTAURANT ASSOCIATE HANDBOOK

California

(Employee keeps)

August 2012

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Our History - Applebee’s Neighborhood Grill & Bar

The first Applebee’s opened in 1980 in Atlanta, Georgia as T.J. Applebee’s Edibles & Elixirs, a neighborhood bar and restaurant. “I had five partners, mortgaged my house and borrowed $50,000 to open the first restaurant”, said Bill Palmer, the founder of the Applebee’s concept, who together with his investors watched their dream become a reality.” “At first we had 17 tables and a long wait.

We added another nine tables and an atrium and sales doubled. Then, it just kept evolving. I knew we had something when the aggressive growth began. It took us ten years to open the first 100 – now we open more than 100 each year”, said Palmer. Palmer sold the Applebee’s concept to W.R. Grace in 1983, but remained one of the company’s most active franchisees. Applebee’s International, Inc. was created in 1988 when Midwestern franchisees Abe Gustin and John Hamra purchased the 54-unit concept from W.R. Grace.

Applebee’s quickly made a name for itself in the restaurant industry thanks to the resolve of Gustin. He believed he could aggressively franchise a casual dining restaurant, a restaurant that offers table service and a full bar. At the time, only fast food franchising was predominant. Applebee’s pioneered casual dining’s use of smaller restaurant facilities and more recently created a prototype casual dining restaurant for use in smaller communities with populations of 25,000. Applebee’s also led the implementation of market penetration strategies in the casual dining segment, creating a presence in a specific area, and then filling in the market afterward.

Applebee’s localizes each restaurant to reflect the neighborhood in which it operates. Each restaurant’s décor reflects local hometown heroes ranging from local athletes and celebrities to firefighters and other notables. The menu offers a wide range of choices from appetizers and salads to steak, chicken and ribs.

In 2007 Applebee’s International was purchased by IHOP Corp and became Applebee’s Services Inc. This created the largest full service restaurant company in the world. In 2008 Applebee’s, along with IHOP, became part of DineEquity Inc. Applebee’s Services Inc. is headquartered in Kansas City, MO and continues to develop, franchise and operate restaurants under the Applebee’s Neighborhood Grill & Bar brand, the largest casual dining concept in the world. Additional information on Applebee’s Services can be found at their website www.applebees.com.

The Apple American Group Team

Apple American Group LLC is a franchisee of Applebee’s Services Inc. Founded in 2001, Apple American Group LLC (AAG) has grown to 436 restaurants with over 25,000 teammates – and we’re poised to continue growing. We are the largest Applebee’s franchisee in the world. We currently own and operate restaurants in: California and Nevada, Washington, Indiana, Ohio, New Jersey and Delaware, Pennsylvania and West Virginia, Minnesota, Wisconsin,Massachusetts, Rhode Island, New York, New Hampshire, Vermont, Maine, Alabama, Colorado, Georgia, Idaho, New Mexico and Oregon.

On 7/23/10, DineEquity, Inc. announced that it had reached agreement with Apple American Group LLC for the sale of 63 company-operated Applebee's restaurants located in Minnesota and parts of Wisconsin. “We are pleased to have reached an agreement to sell our Minnesota and Wisconsin restaurants to our largest Applebee’s franchisee and one of our best operators, Apple American Group. Apple American is a valuable franchise partner who continues to support our menu, marketing and operations revitalization efforts currently underway and is committed to reinvesting in the brand through new restaurant development, acquisition and restaurant remodel programs,” said Julia A. Stewart, DineEquity’s chairman and CEO. In November 2011, Apple American Group acquired another 66 restaurants in New England. The most recent acquisition brought an additional 99 units including 6 states in which AAG had not yet done business. As growth continues, Apple American remains dedicated to making every location a truly neighborhood restaurant responsive to the needs of each guest, each employee, and each community. Visit our website at www.AppleAmerican.com.

Apple American Group LLC is built on a decentralized business model, which means that each geographic area is led by a Market President. Reporting to the Market President are Area Directors, who are multiple unit operators, responsible for the overall functions of the restaurants in their areas. Reporting to the Area Directors are the General Managers, who are the chief restaurant managers responsible for the overall running of their restaurant. Aiding in the management of the restaurant are Assistant Managers, who are responsible for running of their departments (Kitchen, Carside, Service, Bar) and who help with every-day management responsibilities. Rounding out the storeleadership are key employees, team leads, and neighborhood experts.

In addition, all markets are assisted by the Support Center, which is located in Cleveland, Ohio. Company Accounting, Human Resources, Information Technology, Marketing, Payroll, Purchasing, Real Estate, and Training departments are housed at the Support Center, with field representatives available in the markets.

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WELCOME!We’re happy that you have joined Apple American Group (AAG), the premier franchise group in the Applebee’s system. Along with your training, this handbook was written to answer the usual employee questions you may have. If you ever have any questions regarding anything to do with your employment – benefits, payroll, training – please speak with your managers, for they know you are truly our most valuable asset. Thanks for joining our team and good luck with your new job!

Greg Flynn Brad PettingerChairman & CEO Chief Operating Officer

EMPLOYMENT AT WILL

Your employment with AAG is an employment at will. Just as you may quit your employment with us at any time for any reason, AAG may terminate your employment at any time for any reason.

Our policies and procedures in this Handbook aren’t intended to be all inclusive, but rather to serve as a guideline. They are subject to change from time to time at the discretion of management. None of the policies, procedures or benefits contained in this handbook are intended to constitute a contract of employment. Only AAG officers have any authority to enter into any agreement extending the employment of any employee for any specific period of time, or to make any promise or agreement contrary to the rules and policies of Apple American Group. Any such promise or agreement must be in a writing signed by an AAG officer.

EQUAL EMPLOYMENT OPPORTUNITY - AMERICANS WITH DISABILITIES ACT

It is the policy of AAG not to discriminate on the basis of race, creed, color, national origin, sexual orientation, gender identity,religion, medical condition, marital status, genetics sex, age, disability or any other status protected by state or federal law. It is our policy and practice to ensure equal opportunity in employment for all qualified individuals with disabilities in accordance with the Americans with Disabilities Act and similar state laws.

OPEN DOOR POLICY

In any relationship, when a disagreement occurs, keeping emotions bottled up inside only causes the problem to get bigger. At AAG we want to encourage open communication so we can solve the problem with the least amount of stress for those involved. To do this, we have developed an open-door policy that encourages you to talk with your supervisor to get your concern addressed quickly.

Option 1. Talk directly to your immediate supervisor. If you have a problem, first discuss it with your manager as soon as possible after the problem arises.

Option 2. Talk to a higher level of management. If you are not able to resolve the issue with your manager, or if you are not comfortable discussing the issue with your manager, you should take your concern to your Area Director and even the level of Market President get the answers you need. Follow the chain of command as high as you need to go to resolve the problem.

Option 3. Talk with Human Resources. If you have tried the above steps and are not satisfied, or if you are not comfortable talking to management for any reason, you can contact your Human Resources Generalist to get the help you need. This number is found on your Open Door posting in your restaurant.

Option 4. Talk with Support Center. Contact the Support Center Human Resource Dept at 216.525.2775 or Employee Hotline at 800.837.3667, ext. 1300,and ask for help. _________________________________________________________________________________________________Apple American Group (Apple American Group LLC and Apple American Group II LLC) includes the following subsidiaries and affiliates: Apple Delaware LLC, Apple Indiana I LLC, Apple Indiana II LLC, Apple Indiana III LLC, Apple New Jersey LLC, Apple NorCal LLC, WineCountry Apple LLC, Apple Ohio LLC, Apple Pennsylvania LLC, B.T. Woodlipp, Inc, Apple Washington LLC, AppleSoCal LLC, Apple Nevada LLC, Apple Minnesota LLC and Apple New England LLC

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VALUES & BELIEFSGOLD CARD

OUR VISION

To be the premier franchise group in the Applebee’s system, having the best people to do “whatever it takes” to deliver great products and excellent service in a clean and welcoming environment to every guest, each and every time.

GUIDING PRINCIPLESWe will never compromise our integrity. Our standard for ethical behavior must always meet this test: We will be comfortable seeing our actions (and the motive for them) published in the newspaper.

WE BELIEVE

• That creating and keeping customers is the only basis for job security and the foundation for Company growth• That employees are our most valuable asset, and they should be recognized for their contributions to the

Company’s growth• That performance is the only basis for reward• That measurement improves performance• That we should control the selection of people rather than control the people we select• That a positive attitude is the most important attribute of employees• That good employees openly express their opinions, concerns, and ideas and that successful managers listen • That success depends upon the commitment of each individual to our standards, to our goals, and to each other

in celebrating successesWE PLEDGE

To Our Customers:• We will express our appreciation for your patronage• We will treat you as though you are a guest in our home• We will take the initiative to understand your needs and desires• We will strive to exceed your expectations

To Our Fellow Employees:• We will reward you based on your individual and team performance• We will treat you fairly and with dignity and respect• We will encourage and assist each of you to reach your highest level of accomplishment• We will encourage your frank expression of opinions, concerns and ideas• You have a right to know the reasons underlying Company goals, standards and procedures• We will consistently measure your performance and provide accurate and timely feedback• We will provide a clean and safe workplace

To Our Suppliers:• We believe that you are our partners in better serving our customer, therefore:• We will honor our agreements• We will objectively measure supplier performance• We will treat your representatives with respect and value their time• We will honor and maintain confidences

To Our Communities:• We will maintain our properties, obey the law, assist those less fortunate and support those institutions that

enhance the quality of life in our community

To Our Shareholders:• We will earn continued use of shareholders’ capital by developing a management team that will generate

superior returns on capital placed at risk• We will communicate routinely and effectively with our shareholders• We will actively seek new opportunities for sound investment

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EMPLOYMENT POLICIES

RIGHT TO REVISE: This employee handbook contains the employment policies and practices of AAG in effect at the time of publication. All previously issued handbooks and any inconsistent policy statements or memoranda are superseded.

AAG reserves the right to revise, modify, delete, or add to any and all policies, procedures, work rules, or benefits stated in this handbook or in any other document, except for the policy of at-will employment. However, any such changes must be in writing and must be signed by an officer of AAG. Any written changes to this handbook will be distributed to all employees so that employees will be aware of the new policies or procedures. No oral statements or representations can in any way alter the provisions of this handbook. Nothing in this employee handbook or in any other personnel document, including benefit plan descriptions, creates or is intended to create a promise or representation of continued employment for any employee. AAG abides by all federal, state and local laws. Summaries of your legal rights herein are not intended to substitute for actual legal text; at all times, the actual law in effect governs employee rights.

ASSOCIATE BENEFITS

MEALS: Meals When Working -- Front of the House employees receive a 50% discount on food items eaten on premises if they are eating directly before, during, or after their shift. Back of the House employees receive up to $9 meal benefit for each shift they work. The food must be consumed on premises and does not include steaks or baby back ribs. There is also no charge for soda, coffee, and iced tea while on duty. The Market Presidents may modify or discontinue meal benefits at their discretion.

It is the responsibility of management to schedule vacations at whatever time best suits your needs without interfering with the operation of the restaurant. Upon termination of your employment with the Company, you will receive any vacation pay earned. If you have not completed a vacation eligibility year at the time of your termination of employment, you are not eligible to receive a prorated vacation. Questions regarding vacation scheduling, vacation days earned or payment of vacation balances should be referred to your manager, your Human Resources Generalist, or the Employee Hotline at 800.837.3667, ext. 1300.

HEALTH BENEFITS: Associate health benefits are available. Your Manager and/or HR Generalist will provide you with the program information. COORDINATION OF PREGNANCY DISABILITY LEAVE WITH FAMILY/MEDICAL LEAVE: Leave taken under the pregnancy disability policy runs concurrently with family and medical leave under federal law, but not family and medical leave under California Law.

FAMILY AND MEDICAL LEAVE: State and federal family and medical leave laws provide up to 12 workweeks of unpaid family/medical leave within a 12-month period, under the following conditions:

• The employee has more than 12 months of service; • The employee has worked at least 1,250 hours during the previous 12-month period before the need for leave; and • The employee is employed at a work site where there are 50 or more employees within a 75-mile radius.

VACATION: You are eligible for vacation on your 2nd anniversary in the years when you average at least 34.00 hours of work per week for the 52 weeks immediately preceding your anniversary date. On your 2nd and 3rd anniversary of eligible employment you will accrue .0192 hours of vacation time for each 1 hour worked each pay period in the 52 weeksimmediately following your anniversary date of employment. On your 4th anniversary of eligible employment and every anniversary of eligible employment thereafter you will accrue .0385 hours of vacation time for each 1 hour worked each pay period for the 52 weeks immediately following your anniversary date. Vacation accrual will cap at any time the accrued vacation “bank” is equal to or greater than 1.5 times your annual vacation award.

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Leave may be taken for one or more of the following reasons:• The birth of the employee’s child, or placement of a child with the employee for adoption or foster care;• To care for the employee’s spouse, registered domestic partner, child, or parent who has a serious health

condition; or• For a serious health condition that makes the employee unable to perform his or her job.

Under most circumstances, leave under federal and state law will run at the same time and the eligible employee will be entitled to a total of 12 weeks of family and medical leave in the designated 12-month period.

However, leave because of the employee’s disability for pregnancy, childbirth or related medical condition is not counted as time used under California law (the California Family Rights Act). Time off because of pregnancy disability, childbirth or related medical condition does count as family and medical leave under federal law (the Family and Medical Leave Act). Employees who take time off for pregnancy disability and who are eligible for family and medical leave will also be placed on family and medical leave that runs at the same time as their pregnancy disability leave. Once the pregnant employee is no longer disabled, she may apply for leave under the California Family Rights Act, for purposes of baby bonding.

Any leave taken for the birth, adoption, or foster care placement of a child does not have to be taken in one continuous period of time. California Family Rights Act leave taken for the birth or placement of a child will be granted in minimum amounts of two weeks. Any leave taken must be concluded within one year of the birth or placement of the child with the employee.

The following procedures shall apply when an employee requests family leave:• Please contact your Manager or General Manager as soon as you realize the need for family/medical leave.• If the leave is based on the expected birth, placement for adoption or foster care, or planned medical treatment for

a serious health condition of the employee or a family member, the employee must notify the Company at least 30 days before leave is to begin. The employee must consult with his or her manager regarding scheduling of any planned medical treatment or supervision in order to minimize disruption to Company operations. Any such scheduling is subject to the approval of the health care provider of the employee or the health care provider of the employee’s child, parent, or spouse.

• If the employee cannot provide 30 days notice, the Company must be informed as soon as is practical.

If the Family and Medical Leave Act/California Family Rights Act request is made because of the employee’s own serious health condition, AAG may require, at its expense, a second opinion from a health care provider that the Company chooses. The health care provider designated to give a second opinion will not be one who is employed on a regular basis by the Company.

If the second opinion differs from the first opinion, AAG may require, at its expense, the employee to obtain the opinion of a third health care provider designated or approved jointly by the employer and the employee. The opinion of the third health care provider shall be considered final and binding on AAG and the employee.

AAG requires the employee to provide certification within 15 days of any request for family and medical leave under state and federal law, unless it is not practicable to do so. AAG may require recertification from the health care provider if additional leave is required.

If the leave is needed for to care for a sick child, spouse, or parent, the employee must provide a certification from the health care provider stating:

• Date of commencement of the serious health condition;• Probable duration of the condition;• Estimated amount of time for care by the health care provider; and • Confirmation that the serious health condition warrants the participation of the employee.

When both parents are employed by AAG, and request simultaneous leave for the birth or placement for adoption or foster care of a child, the Company will not grant more than a total of 12 workweeks of family/medical leave for this reason.

If an employee cites his/her own serious health condition as a reason for leave, the employee must provide a certification from the health care provider stating:

• Date of commencement of the serious health condition;• Probable duration of the condition; and• Inability of the employee to work at all or perform any one or more of the essential functions of his/her position

because of the serious health condition.

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AAG will require certification by the employee’s health care provider that the employee is fit to return to his or her job.

Failure to provide certification by the health care provider of the employee’s fitness to return to work will result in denial of reinstatement for the employee until the certificate is obtained.

Under most circumstances, upon return from family/medical leave, an employee will be reinstated to his or her original job or to an equivalent job with equivalent pay, benefits, and other employment terms and conditions. However, an employee has no greater right to reinstatement than if he or she had been continuously employed rather than on leave. For example, if an employee on family/medical leave would have been laid off had he or she not gone on leave, or if the employee’s job is eliminated during the leave and no equivalent or comparable job is available, then the employee would not be entitled to reinstatement. In addition, an employee’s use of family/medical leave will not result in the loss of any employment benefit that the employee earned before using family/medical leave.

Leave granted under any of the reasons provided by state and federal law will be counted as family/medical leave and will be considered as part of the 12-workweek entitlement in a 12-month period. The 12-month period is measured forward from the date any employee’s first Family and Medical Leave Act leave begins. Successive 12-month periods commence on the date of an employee’s first use of such leave after the preceding 12-month period has ended. No carryover of unused leave from one 12-month period to the next 12-month period is permitted.

USE OF LEAVE: An employee does not need to use this leave entitlement in one block. Leave can be taken intermittently or on a reduced leave schedule when medically necessary. Employees must make reasonable efforts to schedule leave for planned medical treatment so as not to unduly disrupt the employer’s operations. Military Family Leave due to qualifying exigencies may also be taken on an intermittent basis. Leave may not be taken on an intermittent basis when used to care for the employee’s own child during the first year following birth, or to care for a child placed with the employee for foster care or adoption, unless both the employer and employee agree to such intermittent leave.

SUBSTITUTION OF PAID TIME OFF FOR UNPAID LEAVE: Employees are required to use any earned, but unused vacation during their leave. The substitution of paid leave time for unpaid leave time does not extend the 12-week leave period.

MEDICAL AND OTHER BENEFITS: During an approved family medical leave, AAG will maintain the employee’s health benefits (if any) as if the employee continued to be actively employed. If an employee contributes to his or her own health benefits before the leave, that employee will still be responsible for the payment of that contribution while on leave.

MILITARY FAMILY LEAVE: There are two types of Military Family Leave available.

1. Qualifying exigency leave. Employees meeting the eligibility requirements described above may be entitled to use up to 12 weeks of their Basic FMLA Leave entitlement to address certain qualifying exigencies. Leave may be used if the employee’sspouse, son, or daughter, is on active duty or called to active duty status in the National Guard or Reserves in support of acontingency operation.

Qualifying exigencies may include:• Short-notice deployment (up to 7 days of leave)• Attending certain military events • Arranging for alternative childcare• Addressing certain financial and legal arrangements• Periods of rest and recuperation for the service member (up to 5 days of leave)• Attending certain counseling sessions• Attending post-deployment activities (available for up to 90 days after the termination of the covered service member’s

active duty status) • Other activities arising out of the service member’s active duty or call to active duty and agreed upon by AAG and the

employee

2. Leave to care for a covered service member. There is also a special leave entitlement that permits employees who meet the eligibility requirements for FMLA leave to take up to 26 weeks of leave to care for a covered service member during a single 12-month period. A covered service member is a current member of the Armed Forces, including a member of the National Guard or Reserves, who has been rendered medically unfit to perform his or her duties due to a serious injury or illness incurred in the line of duty while on active duty that may render the service member medically unfit to perform his or her duties for which the service member is undergoing medical treatment, recuperation, or therapy; or is in outpatient status; or is on the temporary disability retired list.

When both husband and wife work for the same employer, the aggregate amount of leave that can be taken by the husband and wife to care for a covered service member is 26 weeks in a single 12-month period.

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MILITARY LEAVE: Employees who wish to serve in the military and take military leave should contact their Human Resources Generalist or the Employee Hotline (800-837-3667, ext. 1300) for information about their rights before and after such leave. Employees are entitled to reinstatement upon completion of military service, provided they return or apply for reinstatement within the time allowed by law.

MILITARY SPOUSE LEAVE: Employees who work more than 20 hours per week and have a spouse in the Armed Forces, National Guard or Reserves who have been deployed during a period of military conflict are eligible for up to 10 unpaid days off when their spouse is on leave from (not returning from) military deployment.

Employees must request this leave in writing to their Manager or General Manager within two business days of receiving official notice that their spouse will be on leave. Employees requesting this leave are required to attach to the leave requestwritten documentation certifying the spouse will be on leave from deployment.Additionally, the Family and Medical Leave Act (FMLA) provides up to 26 weeks of leave during a 12 month period for spouses, parents, children, or next of kin (defined as “nearest blood relative”) to care for recovering military service personnel who develop a serious injury or illness while serving in the armed forces.

Employees interested in the foregoing leaves should see their Human Resources Generalist or call the Employee Hotline at (800-837-8667, ext. 1300) for further information.

PREGNANCY DISABILITY LEAVE: Pregnancy, childbirth, or related medical conditions will be treated like any other disability, and an employee on leave will be eligible for temporary disability benefits in the same amount and degree as any other employee on leave.

Any female employee planning to take pregnancy disability leave should advise her Manger or General Manager as early as possible.

The individual should make an appointment with the Human Resources Generalist to discuss the following conditions:• Employees who need to take pregnancy disability must inform AAG when a leave is expected to begin and how

long it will likely last. If the need for a leave or transfer is foreseeable, employees must provide notification at least 30 days before the pregnancy disability leave or transfer is to begin. Employees must consult with the Human Resources Generalist regarding the scheduling of any planned medical treatment or supervision in order to minimize disruption to the operations of the Company. Any such scheduling is subject to the approval of the employee’s health care provider;

• If 30 days’ advance notice is not possible, notice must be given as soon as practical;• Upon the request of an employee and recommendation of the employee’s physician, the employee’s work

assignment may be changed if necessary to protect the health and safety of the employee and her child;• Requests for transfers of job duties will be reasonably accommodated if the job and security rights of others are not

breached;• Temporary transfers due to health considerations will be granted when possible. However, the transferred

employee will receive the pay that accompanies the job, as is the case with any other temporary transfer due totemporary health reasons;

• Pregnancy leave usually begins when ordered by the employee’s physician. The employee must provide AAG with a certification from a health care provider. The certification indicating disability should contain:

The date on which the employee became disabled due to pregnancy; The probable duration of the period or periods of disability; and A statement that, due to the disability, the employee is unable to perform one or more of the

essential functions of her position without undue risk to herself, the successful completion of her pregnancy, or to other persons.

• Leave returns will be allowed only when the employee’s physician sends a release;• Duration of the leave will be determined by the advice of the employee’s physician, but employees disabled by

pregnancy may take up to four months. The four months of leave includes any period of time for actual disability caused by the employee’s pregnancy, childbirth, or related medical condition. This includes leave for severe morning sickness and for prenatal care.

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Under most circumstances, upon submission of a medical certification that an employee is able to return to work from a pregnancy disability leave, an employee will be reinstated to her same position held at the time the leave began or to an equivalent position, if available. An employee returning from a pregnancy disability leave has no greater right to reinstatement than if the employee had been continuously employed.

BEREAVEMENT LEAVE: Employees are eligible for up to three days of unpaid bereavement leave. An employee needing bereavement leave should notify his or her supervisor immediately.

JURY/WITNESS DUTY: AAG considers jury duty a civic responsibility and will make arrangements for an employee to be absent from work to serve on a jury or as a witness in a court case. Employees requiring such leave must inform their Manager or General Manager and provide a copy of the summons or other legal proof that their presence is requested.Employees on jury/witness leave must keep management up to date on their jury/witness duty schedule. Jury/witness duty is an unpaid absence.

STUDENT LEAVE: An unpaid leave of absence may be allowed for qualified students who work for AAG during breaks from school. Employees approved for student leave are allowed to return to AAG employment during breaks from school without having to repeat the application, hiring and orientation process. To be eligible for student leave, an employee must be in good standing with the Company.

Employees requesting Student Leave must notify their General Manager no less than 2 weeks prior to departure for school. Student Leaves are approved by the General Manager and are granted at the General Manager’s discretion.

Failure to return to work with AAG after 6 months will be considered voluntary resignation.

OTHER LEAVE: Provided the appropriate documentation is produced, unpaid time off may be available to employees who are (1) victims of domestic violence or other crimes, (2) volunteers for civil air patrol, firefighters, peace officers, or emergency rescue personnel, (3) participants in a child’s school activities, and (4) organ and bone marrow donors. Employees interested in the foregoing leaves should see their Human Resources Generalist or call the Employee Hotline at (800-837-8667, ext. 1300) for further information.

Note that the foregoing are summaries only and other restrictions and qualifications may apply. For specific and detailed information about these leaves of absence, contact your Human Resources Generalist or call the Employee Hotline at 800.837.3667, ext. 1300.

PAY POLICIESGARNISHMENTS: AAG will comply with all court orders to withhold money from employee paychecks. Garnishments are processed by the Support Center Payroll department. Any questions about your garnishment should be directed to that department at 800.837.3667, ext. 1300.

MEAL AND REST PERIODS: All hourly employees are entitled to periodic rest break periods during their workday. Hourly associateswill be paid for all rest break periods and will not clock out. Managers will advise employees of the time and duration of rest breaks and employees are expected to return to work promptly at the end of any rest break.

REST PERIOD TABLE –HOURS WORKED REST PERIODS (CALIFORNIA)Less than 3.5 hours worked Rest period need not be authorized for employees

whose total daily work time is less than 3.5 hours3.5 to 6 hours worked A total of 1 10-minute rest periodMore than 6 hours worked to 10 hours worked A total of 2 10-minute rest periodsMore than 10 hours worked to 14 hours worked A total of 3 10-minute rest periods

MEAL PERIOD TABLE –HOURS WORKED MEAL PERIODS (CALIFORNIA)Work period of more than 5 hours 1 30-minute meal period (if total work period per day

is 6 hours or less, the meal period may be waived by mutual consent)

Work period of more than 10 hours 2 30-minute meal periods (if total hours worked is no more than 12 hours, the second meal period may be waived by mutual consent only if the first meal period was not waived)

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Employees must clock out for meal periods. Managers will advise employees of the scheduling of meal periods. Employees must not perform any work during their meal periods, and must stop working for at least 30 full, consecutive minutes. Employees may, if they choose, waive their first or second meal break. If you choose to waive your meal break, you will be asked to sign a form indicating your consent. Please see your manager for details.

All rest breaks and meal periods must be taken away from the regular work area. Employees may leave the premises for meal periods.

These breaks from work are not optional but required by state law. Subject to the meal break waivers provided in the attached booklet, we are required to provide all breaks.. Proper clocking-out and clocking-in is the employee’s responsibility. Failure to follow these requirements places our company at risk and may result in discipline up to and including termination. Any employee who does not waive his or her meal break and fails to take the applicable rest breaks and/or meal periods must notify the Manager or General Manager immediately.

MEETINGS: Meetings are occasionally held to discuss new policies, new menu items, or new procedures. Employees will be paid at least minimum wage for these meetings and attendance is required unless excused by the General Manager. If an employee misses a meeting and it was not excused by the General Manager, it will count as an unexcused missed shift.

OVERTIME: Employees may be required to work overtime as necessary. Only actual hours worked in a given workdayor workweek can apply in calculating overtime. All overtime work must be previously authorized by a manager. AAGprovides compensation for all overtime hours worked by hourly employees in accordance with state and federal law as follows:

• All hours worked in excess of eight hours in one workday or 40 hours in one workweek will be treated as overtime. A workday begins at 04:01am and ends at 04:00am 24 hours later. Workweeks begin each Wednesdayat 04:00 am;• Compensation for hours in excess of 40 for the workweek, or in excess of eight and not more than 12 for the workday, and for the first eight hours on the seventh consecutive day of work in one workweek, shall be paid at a rate one and one-half times the employee's regular rate of pay; and• Compensation for hours in excess of 12 in one workday and in excess of eight on the seventh consecutive workday in a workweek shall be paid at double the regular rate of pay.Employees with questions about how overtime is calculated should consult management, the Human Resources Generalist, or the Support Center Payroll Department at 800-837-3667.

PAYDAYS: Our pay week runs from Wednesday through Tuesday. In compliance with State law, employees will be paid bi-weekly on the Tuesday following the end of the pay week.

Employees may not cash paychecks at work. Direct Deposit is not mandatory, but all employees are eligible for direct deposit. To sign up for direct deposit, talk with your General Manager. Lost checks should be immediately reported to a manager. Please check your paycheck carefully. If you believe an error has been made, it is your responsibility to call it to the attention of a manager.

PAYROLL DEDUCTIONS: The following list represents deductions you may notice on your paycheck /direct deposit stub:• TAXES**

o Federal Income Taxo State Income Taxo City/Local Income Taxo Social Security (FICA) Taxo Federal Medicare Tax

• OTHER ITEMS DESIGNATED BY EMPLOYEE**State and local taxes vary depending on your local laws.

TIME KEEPING: All sales terminals have a time keeping feature that acts as a time clock. Employees are assigned a specific employee number, and are required to clock in and clock out for each shift and unpaid break. If an employee forgets to clock in or out, and a manager is required to make a change in the system, the employee will need to verify the change with the manager by signing a form stating it has been reviewed with the manager. Repeatedly forgetting to clock in or out will lead to performance counseling, up to and including termination.

No non-management employee is allowed to clock in or out for an employee; and managers can only clock employees in/out with the employee’s signature verifying the action. Employees cannot clock in prior to a shift or after the shift is completed without manager approval. Time clock records are required by state and federal law – if we discover an employee has manipulated a clock record, that employee will receive performance counseling up to and including termination.

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TIPS: Neither AAG nor its managers, directors or executives are permitted to share or keep any part of any gratuity left for employees. “Tip pooling,” whereby employees pool a portion of their tips and then share those tips with other employees, is strictly voluntary.

GENERAL INFORMATIONDISPUTE RESOLUTION PROGRAM: Included in this handbook is our complete Dispute Resolution Program booklet that explains our formal Dispute Resolution Program in detail, and provides clear description of what is covered under the program.

EMPLOYEE PROPERTY: An employee’s personal property, including but not limited to lockers, packages, purses, and backpacks, may be inspected upon reasonable suspicion of unauthorized possession of AAG property or illegal/improper substances.

NAMES AND ADDRESSES: AAG is required by law to keep current all employees’ names and addresses. Employees are responsible for notifying AAG in the event of a name or address change. Employees should also notify AAG if there is a change in phone number, marital status, number of dependents or emergency contact.

SCHEDULING AND POSITION: AAG reserves the right to schedule employees in any position for which they are trained at any time. Neither tenure nor past practice guarantees any employee the right to a particular schedule, number of hours or position.

WORKPLACE PRIVACY: Employees may not use any cameras, audio or video recording devices in or around the restaurant.

AAG PROPERTYBULLETIN BOARDS: A bulletin board is posted to serve as a means of communication between AAG and restaurants, between employee on different shifts, and between management and employees. It is to be used for official business only, and all postings must have management approval. Please check the board when arriving for work and when leaving the premises at the end of a shift for pertinent information.

OFFICE: The Manager’s Office is off-limits unless you are accompanied by a manager.

SOLICITATION AND DISTRIBUTION OF LITERATURE: In order to ensure efficient operation of AAG’s business and to prevent disruption to employees, we have established control of solicitations and distribution of literature on AAG property. AAG has enacted rules applicable to all employees governing solicitation, distribution of written material, and entry onto the premises and work areas. All employees are expected to comply strictly with these rules. Any employee who is in doubt concerning the application of these rules should consult with his or her manager.

• No employee shall solicit or promote support for any cause or organization during his or her working time or during the working time of the employee or employees at whom such activity is directed.

• No employee shall distribute or circulate any written or printed material in work areas at any time, or during his or her working time or during the working time of the employee or employees at whom such activity is directed

Under no circumstances will non-employees be permitted to solicit or to distribute written material for any purpose on AAG property.

TELEPHONES: Restaurant telephones are for business use and to provide extra service for our guests. They cannot be used for employee personal business except in an emergency situation.

EMPLOYEE CONDUCTALCOHOL AWARENESS: Any employee who does not “card” guests (verify guests who appear to be 30 or under by asking for proper ID) ordering alcoholic beverages will be terminated. Any employee who serves alcoholic beverages to someone who is clearly intoxicated will be terminated. We will do whatever it takes to assure that a guest drinks responsibly and gets to their destination safely. Restaurant managers will communicate procedures for dealing with alcohol issues.

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ATTENDANCE: Employees are expected to be at work, ready to go, at the scheduled start time and to stay until the completion of your shift. Tardiness is grounds for performance counseling. An employee who can’t appear for a scheduled shift must call their manager at least 3 hours before the shift begins. The absence of an ill employee may be excused if the employee provides a doctor’s release within 48 hours after returning to work.

To avoid discipline, employees who cannot work an assigned shift can arrange to have another team member cover the shift or trade with another team member. Any changes to the schedule must be approved by a manager.

NOTE: It is your responsibility to make sure proper notification of scheduling conflicts/absences is given. Notification received from another employee, friend or relative is not considered proper, except under emergency conditions. You must also speak with a manager – telling a fellow on-duty employee that you won’t be in is not acceptable and will lead to disciplinary action.

CASH SHORTAGES: AAG will use employee counseling, up to / including termination of employment for any cash shortage. If there is a cash shortage due to gross negligence, dishonesty or a willful act on the part of an employee, AAG reserves the right to pursue legal means of repayment from that employee.

CELL PHONES AND OTHER DEVICES: Employees may not use or carry a cell phone while on the clock. The same is true for a pager, Blackberry, iPhone or any other communications device. If there is a specific concern or emergency, an employee must ask a manager for an exception for a specific shift.

CONDUCTING PERSONAL BUSINESS: Employees are to conduct only AAG business while at work. Employees may not conduct personal business or business for another employer during their scheduled working hours.

DISCIPLINARY ACTION: Violation of AAG policies and rules (including engaging in conduct listed herein as Prohibited Conduct) may warrant disciplinary action. AAG may, in its sole discretion, utilize whatever form of discipline is deemed appropriate under the circumstances, up to, and including, termination of employment. AAG’s policy of discipline in no way limits or alters the at-will employment relationship.

DRINKING AT APPLEBEE’S OFF THE CLOCK: Employees of legal drinking age, will be permitted to consume alcoholic beverages in any AAG Applebee’s restaurant with a maximum of 2 (two) alcoholic beverages IF the following requirements are met:

• Must pay full price for alcoholic beverages• Must refrain from any behavior/language that is less than professional or not in the best interest of guests,

co-workers, or the employer.• May not consume any alcoholic beverages within 4 (four) hours prior to the start of their shift or prior to visiting

another Applebee’s restaurant to work in any capacity.• May NOT enter the BOH or the immediate bar area (excluding High-top tables) while consuming alcohol.• Must be off-duty and not in any Applebee’s uniform.

All managers and supervisors have the responsibility to enforce this policy and all employees must report any violation or potential violation to their immediate supervisor and/or the Human Resources representative immediately. Failure either to enforce or adhere to this policy may result in immediate disciplinary action up to and including termination.

Drinking privileges for employees at Applebee’s restaurants will be at the sole discretion of AAG. Consult the restaurant manager for additional information about employees as off-duty guests in our restaurants.

DRUG AND ALCOHOL ABUSE: The following rules and standards of conduct apply to all employees either on AAGproperty or during the workday (including meal periods). Behavior that violates AAG policy includes:

• Possession or use of an illegal or controlled substance;• Being under the influence of an illegal or controlled substance while on the job; and• Distribution, sale, or purchase of an illegal or controlled substance while on the job.

Violation of these rules and standards of conduct will not be tolerated. AAG also may bring the matter to the attention of appropriate law enforcement authorities.

In order to enforce this policy, AAG reserves the right to conduct searches of AAG property or employees and/or their personal property, and to implement other measures necessary to deter and detect abuse of this policy.

Any employee who is using prescription or over-the-counter drugs that may impair the employee’s ability to safely perform the job, or affect the safety or well-being of others, must notify a manager of such use immediately before starting or resuming work.

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EMPLOYEE HOTLINE: Do you need help with a problem? If you have a work-related problem that seems insurmountable, and you’ve gone through channels and are still not satisfied, try our Hotline to get help with: problems relating to your employment; payroll/benefits questions or problems. Call 800.837.3667, ext. 1300.

GUEST TREATMENT: It is against Apple American Group policy for an associate of AAG to make negative or derogatory remarks about a guest to anyone, including fellow employees. Speaking to a guest about the amount of tip is grounds for immediate suspension and possible termination. Employees may not pressure hosts to have a specific type of guest in their section.

LOST AND FOUND: Any item found in the restaurant or on the property by an employee is to be turned over to the manageron duty immediately.

PARKING: Employee parking is a "house" policy. Your manager will tell you if you will be required to park in a specific area.

PROMOTIONS: Apple American is always looking for career-minded internal candidates. If you are interested in another position, notify your manager. Promotions are determined by merit, not length of time with AAG.

SMOKING: Employee smoking is restricted to specific times and areas which are determined by management. The Smoking Policy for your restaurant will be posted where other employee notices are located. Smoking is never permitted (1) in the restaurant, (2) while in public view or (3) in public areas while employees are in work clothes. Smoking in areas and at times that are prohibited may result in termination.

STAYING AFTER HOURS: We understand that after work employees may want to relax and unwind as guests. Managers will advise employees regarding specific restaurant policies on whether and when staying after hours is acceptable. Employees who are not “on the clock” cannot do any work, even if they just want to “help out” coworkers.

WORK CLOTHES: AAG, as an Applebee’s franchise, requires its employees to wear an Applebee’s name badge &apron, provided by AAG. We’ll also require that you wear certain styles shirt and pants and possibly other items thatcould be a part of your basic street clothing and that you can buy at a variety of stores. We will provide you a free “start-up” name badge and apron as these are specifically Applebee’s. Clean nails, hands, teeth, and the use of an effective deodorant are a must in the restaurant business. Your clothing must be clean and wrinkle-free. Your shoes must be non-slip soled shoes - Additional requirements include:

Front of House Positions• Hair must be clean and pulled back away from face.• Hair must be restrained if shoulder length or longer, and always away from items being served.• Make-up should be simple and applied lightly.• GM or AD will approve the length of mustaches, sideburns and beards. While growing a beard, daily shaving &

shaping of the beard is required.• Manicures must be well-maintained – no chipping. Clear polish only. White French-tip also allowed.• Tattoos and body piercing (other than ears) must be concealed from guests’ view.• Hair color and style should be conservative.• Jewelry should be kept to a minimum; management reserves the right to approve appropriateness.• Perfume, colognes, and aftershave must be fresh and lightly scented. No heavy scents are permitted.• Clothing must be clean (not stained); not worn, free of fraying or holes and wrinkle-free. Socks are required.• T-shirts worn under a FOH shirt must be a V-neck and not visible to guests.• Intentional body alteration or modification for the purpose of achieving a visible, physical effect that disfigures,

deforms or similarly detracts from a professional image is prohibited. Examples include, but are not limited to,visible tattoos, brands, body piercing (other than traditional ear piercing), tongue piercing or splitting, tooth filing,earlobe expansion, and acquiring visible, disfiguring skin implants.

• Methods to conceal an unacceptable piercing, such as using a bandage, are not permitted. For tattoo coverage, adiscrete bandage or opaque makeup will be permitted if they completely conceal the tattoo. Spacers or retainersare not permitted in any visible body piercing while working. Jewelry worn in non-visible piercings that may pose asafety risk because of working clothes design and/or job responsibilities will not be permitted.

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Front of the House Dress Code

• BLACK PANTS: Casual style, all black, loose fitting casual slacks (Dockers style), with belt loops and a maximum of 2 front and 2 rear pockets. Pants can have a cuff or no cuff, but cannot touch the floor.

• BELT: Solid, plain black belt 1 inch to 1 ½ inches wide.• SOCKS: Black socks.• BLACK SHOES: Must be leather, with non-skid soles (see approved styles). NO EXCEPTIONS.• SHIRT: Button down, solid black long sleeve or short sleeve shirt with collar for FOH employees. Additionally V-Neck blouses

and other feminine cut shirts can be worn with permission of the General Manager. Long sleeve shirts cannot be rolled up. All shirts must be tucked into pants with the exception of certain feminine tailored shirts that will not need tucked in, providing theshirt is no more than 3 inches below the waist line of pants. T-shirts can be worn but cannot be visible to the guest.

• BLACK APRONS: Servers will wear black aprons, which will be provided to them.• NAME TAG: Approved Applebee’s Name Tag.

Back of House Positions

• Applebee’s shirts and hats are required.• Jeans or pants with no holes – no sweats.• No excessive jewelry.• No shorts at any time.• Socks are required.• BLACK SHOES: Must be leather, with non-skid soles (see approved styles). NO EXCEPTIONS.

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PROHIBITED CONDUCTThe following conduct is prohibited and will not be tolerated by AAG. This list of prohibited conduct is illustrative only; other types of conduct that threaten security, personal safety, employee welfare and AAG operations also may be prohibited.

• Falsifying employment records, employment information, or other AAG records (note that employment information includes Social Security Numbers and any other documents used to verify identity and ability to work in the United States);

• Recording the work time of another employee or allowing any other employee to record your work time, or falsifying any time record, either your own or another employee’s;

• Theft and deliberate or careless damage or destruction of any AAG property, or the property of any employee or customer;

• Removing or borrowing AAG property without prior authorization;• Unauthorized use of AAG equipment, time, materials, or facilities;• Provoking a fight or fighting during working hours or on AAG property;• Participating in horseplay or practical jokes on AAG time or on AAG premises;• Carrying firearms or any other dangerous weapons on AAG premises at any time;• Engaging in criminal conduct whether or not related to job performance;• Causing, creating, or participating in a disruption of any kind during working hours on AAG property;• Insubordination, including but not limited to failure or refusal to obey the orders or instructions of a supervisor or

member of management, or the use of abusive or threatening language toward a supervisor or member of management;

• Using abusive language at any time on AAG premises;• Failing to personally notify a supervisor when unable to report to work and returning without doctor’s note;• Violation of AAG’s social media policies;• Unexcused absence; • Failing to obtain permission to leave work for any reason during normal working hours;• Failing to observe working schedules, including rest and lunch periods;• Failing to provide a physician’s certificate when requested or required to do so;• Sleeping or malingering on the job;• Violating AAG’s alcohol policies;• Working overtime without authorization or refusing to work assigned overtime;• Wearing disturbing, unprofessional or inappropriate styles of dress or hair while working;• Violating any safety, health, security or AAG policy, rule, or procedure;• Violating other policies within this handbook;• Committing a fraudulent act or a breach of trust under any circumstances;• Committing of or involvement in any act of unlawful harassment of another individual; and• Failing to promptly report work-related injury or illness.

This statement of prohibited conduct does not alter AAG's policy of at-will employment. Either you or AAG remain free to terminate the employment relationship at any time, with or without reason or advance notice.

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SAFETY AND HEALTHACCIDENT REPORTING: Any employee who suffers an accidental injury, no matter how minor, must be reported to management immediately. This is a Government requirement placed on both employee and employer.

EQUIPMENT: Care is required in the handling of all equipment and supplies. It is expected that employees will handle all equipment as instructed. This policy applies to all areas and departments of the restaurant.

GENERAL SAFETY POLICY: All employees are responsible for their own safety, as well as that of others in the workplace. To help us maintain a safe workplace, everyone must be safety-conscious at all times. Report all work-related injuries or illnesses immediately to management. In compliance with California law, and to promote the concept of a safe workplace, AAG maintains an Injury and Illness Prevention Program. The Injury and Illness Prevention Program is available for review by employees and/or employee representatives in the General Manager’s office.

HAZARDS: All safety hazards such as broken equipment, damaged machinery or tools, or slippery floors should be reported to the manager immediately.

OBJECTS ON THE FLOOR: Immediately pick up anything dropped on the floor and any foreign object on the floor. Keep aisles, halls and walkways free from electric cords or hoses.

SECURITY: Be aware of persons loitering for no apparent reason in parking areas, walkways, entrances and exits, and service areas. Report any suspicious persons or activities to management. Do not leave valuable and/or personal articles in the restaurant where they are accessible. AAG is not responsible for personal belongings brought into the restaurant

SLIPPERY FLOORS: For safety’s sake, wipe up any spill at once--and wipe it dry. If you must walk on wet, slippery floors, slow down and take short firm steps.

WORKPLACE VIOLENCE: AAG has a zero tolerance for acts of violence and threats of violence. Without exception, acts and threats of violence are not permitted. All such acts and threats, even those made in apparent jest, will be taken seriously, and will lead to discipline up to and including termination.

A threat includes, but is not limited to, any indication of intent to harm a person or damage AAG property. Threats may be director indirect, and they may be communicated verbally or nonverbally.

Possession of weapons on AAG premises and at AAG-sponsored events shall constitute a threat of violence. Employees may not possess a firearm on AAG property regardless of whether or not they have a permit. Other prohibited items are: explosives, knives and other dangerous weapons, including chemical substances intended to cause injury to another.

It is every employee’s responsibility to assist in establishing and maintaining a violence-free work environment. Therefore, each employee is expected and encouraged to report any weapon or incident which may be threatening or violent. Employees may submit a report to any manager, Human Resources Generalist or via the Employee Hotline (800-837-3667, ext. 1300).

LEAVING AAGEMPLOYEE REFERENCES: All requests for references must be directed to your Human Resources Generalist. No other manager or employee is authorized to release references for current or former employees. AAG’s policy is to only disclose the dates of employment and the title of the last position held of former employees. If an employee authorizes the disclosure in writing, AAG also will inform prospective employers of the amount of salary or wage the employee last earned.

NOTICE: If an employee must resign, we request a written 2-week notice, so that we can plan accordingly. During the final 2 weeks, we expect that employees will continue to perform their job duties properly. Providing notice does not alter the at-will status of your employment and AAG may accept your resignation immediately or at any time during the notice period.

VOLUNTARY RESIGNATION: Voluntary resignation results when an employee voluntarily quits his or her employment at AAG or, in the absence of a severe, unforeseeable medical emergency that is verified by a medical professional, fails to report to work for two (2) scheduled workdays without notice to, or approval by, his or her manager. All AAG-owned property, including keys, must be returned immediately upon termination of employment.

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DISPUTE RESOLUTION PROGRAM[2004EDR Systems, LLC/All Rights Reserved/Revised 2011]

This Dispute Resolution Program is adopted for Apple American Group (Apple American Group LLC and AppleAmerican Group II LLC) and all subsidiaries or affiliated entities, and all successors and assigns of any of them, all of which are collectively hereinafter referred to as the “Company.”

The Company is committed to building a strong relationship between the Company and all of our employees - arelationship that is based on trust and open communication. The Company is an equal opportunity employer andstrives to maintain an atmosphere of mutual trust and open, honest communication. By working together, we can reachany goal we set for ourselves. We do not and will not tolerate harassment or discrimination by any employee,regardless of their status with the Company, and no employee will be retaliated against for using this Program.

We understand, however, that problems and disagreements are unavoidable when people with different viewpointsspend a lot of time together. We cannot entirely eliminate disagreements, but we can provide a process for resolvingthem when they do occur by taking prompt constructive action.

Based on these beliefs and values, we developed this DISPUTE RESOLUTION PROGRAM (the “Program”). The Program is a four- step process for resolving workplace problems quickly and fairly. This policy describes the steps that both you and the Company must take to resolve many types of workplace problems. The Company is also obligated tofollow the Program and will also be bound by arbitration. The types of problems covered by the Program are explainedin detail in this policy.

THIS PROGRAM IS A CONDITION OF YOUR EMPLOYMENT AND IS THE MANDATORY AND EXCLUSIVE MEANSBY WHICH DISPUTES BETWEEN YOU AND THE COMPANY MAY BE RESOLVED, SO READ THE INFORMATIONIN THIS PROGRAM BOOKLET CAREFULLY.

When you have a work-related problem, follow the steps listed below in this policy.

Step 1: UTILIZE THE OPEN DOOR POLICYIn any relationship, when a disagreement occurs, keeping emotions bottled up inside only causes the problem to get bigger. At the Company we want to encourage open communication so we can solve the problem with the least amount of stress for those involved. To do this, we have developed an Open-Door Policy that encourages you to talkwith your manager to get your concerns addressed quickly.1. Talk directly to your immediate manager. If you have a problem, first discuss it with your Manager or General Manager as soon as possible after the problem arises.2. Talk to a higher level of management. Sometimes, you may not be able to resolve the issue with your Manager or General Manager. If this is the case, take your concern to your Area Director, Director of Operations or upto the Market President to get the answers you need.3. Talk with Human Resources. If you have tried the above steps and are not satisfied, or if you are not comfortable talking to your managers for any reason, you can contact your Human Resources Generalist to get the helpyou need.4. Talk with Support Center. If for any reason you are uncomfortable with following the prior steps, you shouldfeel free to contact the Support Center Human Resource Dept. at 216.525.2775 or Employee Hotline at 800.837.3667 x1300 and ask for help.

Step 2: EXECUTIVE REVIEWIf you have tried the Open Door Policy and are not satisfied, you may request the Executive Review Step. In this step, the Company’s President or his designee (the “Executive”) will review the issue or problem and attempt to resolve theissue or problem to your satisfaction and to the satisfaction of your Manager and the Company. Failing that, theExecutive will make a decision.

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Here is how you obtain access to the Executive Review Step:

1. Request review. As soon as possible after your exhaustion of the Open Door Policy Step process, you canstart the Executive Review process by contacting the Company’s Employee Relations department. The EmployeeRelations department can be reached at 216.525.2775 or you can call the Employee Hotline at 800.837.3667 x1300 and ask for help.2. Submit information. In order to access the Executive Review Step, you should provide a written statement thatcontains as much of the following information as is reasonably available to you:a. Describe in detail, to the best of your ability, the factual basis on which your claim is made.b. Describe the measures you have taken at the Communication Step to resolve the issue including the supervisorsyou have spoken with about the problem.c. Describe the nature and extent of any remedy or relief you believe you should have.*You can obtain a copy of a form to use for this purpose from the Human Resources Department.3. The Review. The Company’s Executive will review the problem and make whatever investigation he believes isappropriate under the circumstances. This may include, in all likelihood, a discussion with you and your Manager and areview of all relevant documents.4. The Solution. The Executive will attempt to find a way to resolve the problem to the satisfaction of all theparties involved in the situation. However, if the problem cannot be resolved in this manner, the Executive will make adecision. That decision will be made in writing, generally within thirty (30) days of your request for executive review.5. Non-Legal Claims. If your claim is not a statutory or common law claim (“legal claim”), Executive Review is thefinal step in the Dispute Resolution Program. (Only legal claims may proceed to mediation or arbitration). For example,mediation and arbitration are not available to review performance evaluations, job elimination or lay-off decisions,Company work rules, policies and pay rates, or increases or decreases in benefits, except to the extent such mattersrelate to statutory or common law claims.

Step 3: MEDIATIONIf you believe you have a legal claim that was not solved through the Open Door Policy or Executive Review, the nextstep is Mediation. In Mediation, an objective, independent third party tries to help the parties reach a mutually agreeablesolution.

When you or the Company requests Mediation, the Company will contact the American Arbitration Association (AAA) or a similar organization specializing in dispute resolution. The agency will assign a professional mediator to mediate thedispute. The mediator will listen, work to open communication lines, and offer creative solutions. But the mediatordoes not make a final decision. It is up to you and the Company to reach agreement. The goal of mediation is todevelop a solution that satisfies both parties involved.

Here is how to put the Mediation Step to work for you:

1. Advise the Employee Relations department that you request Mediation. You should request Mediation assoon as possible, generally within sixty (60) days from the date you complete the Executive Review Step, so that the issues will be fresh in your mind. You will be requested to complete a Request for Mediation form, which will befurnished.2. Select mediator. When either you or the Company request Mediation, the parties will select an outside, independent neutral mediator to handle the mediation process. The Company will pay the fees of the mediator and themediation agency.3. You, the mediator and the Company representative meet. The mediator will schedule a meeting between you and the Company representative. The mediator will guide the discussion and help resolve the problem. However, it is up to both you and the Company to reach agreement. The mediator does not make the final decision.4. Written agreement. If appropriate, after you and the Company have agreed upon a solution, a writtenagreement will be signed by the parties.

Step 4: ARBITRATIONIf you have a work-related problem that involves one of your legally protected rights, which has not been resolved through the earlier steps, you may request Arbitration.

In Arbitration, an outside neutral expert chosen and agreed upon by you and the Compnay, called an “arbitrator”,becomes involved in the resolution process. He or she listens to the facts, then makes a final binding decision andawards any damages, just like a judge in a court of law. Arbitration is less formal than conventional court litigation butis clearly established and governed by rules and standards of conduct, which are designed to assure due process of law is fully protected. The goal of Arbitration is to provide effective and efficient problem resolution.

Here is how the Arbitration process works:

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1. Request Arbitration. If you believe you have a legal claim, you may request that your claim go to Arbitration.Simply complete an Arbitration Request Form (provided upon request) and return it to the Company at its Cleveland, Ohio Support Center addressed to the attention of the Apple American Group Employee Relation Department, 6200 Oak Tree Blvd, Suite 250, Independence, Ohio 44131. The form can be obtained from your Human ResourcesGeneralist. The Arbitration will be conducted by the AAA or any similar organization mutually acceptable to you and theCompany. The arbitration will be conducted under the AAA’s “National Rules for the Resolution of Employment Disputes”, which are in effect at the time the demand for arbitration is filed. The rules can be obtained from the AAA’swebsite at ADR.org or from the Company upon request.

The arbitration agency selected (the “agency”) will then bill you and the Company each a filing fee. Your portion of thatfee is limited to$125.00. The Company will pay the balance of the agency’s initial filing fee and will pay the arbitrator’s fee. If youestablish that you cannot pay the filing fee, the Company will pay your portion of the fee.

2. A hearing is set. The arbitrator will schedule a date, time and place for a hearing. During this hearing, both youand the Company present the pertinent facts, documents, and witnesses. You may hire a lawyer to participate in theArbitration hearing with you. The hearing will be conducted in the community where you are/were employed by the Company or in another mutually agreeable location.

3. A decision is made. Based on the information presented and the facts gathered, the arbitrator will make a finalbinding decision in writing that will set forth the essential findings and conclusions on which the award is based. The decision of arbitrator shall have a final and binding effect in any related litigation. If you win, the arbitrator can award you anything you might seek through a court of law. By using Arbitration, your rights are protected and damages canbe paid if those rights have been violated.

PROGRAM RULES CLAIMS SUBJECT TO ARBITRATIONClaims and disputes subject to arbitration include all those legal claims you may now or in the future have against theCompany or against its officers, directors, shareholders, employees or agents, including claims related to any Companyemployee benefit program or against its fiduciaries or administrators (in their personal or official capacity), and all claimsthat the Company may now or in the future have against you, whether or not arising out of your employment or termination, except as expressly excluded under the “Claims Not Subject to Arbitration” section.

Legal claims that are subject to arbitration include, but are not limited to: claims for wages or other compensation; claims for breach of any contract, covenant or warranty (expressed or implied); tort claims (including, but not limited to, claims for physical, mental or psychological injury, but excluding statutory

workers compensation claims); claims for wrongful termination; claims for sexual or other illegal harassment or discrimination (including, but not limited to, claims based on race,

sex, sexual orientation, religion, national origin, age, medical condition or disability whether under federal, state or local law);

claims for benefits or claims for damages or other remedies under any employee benefit program sponsored by the Company (after exhausting administrative remedies under the terms of such plans);

“whistleblower” claims under any federal, state or other governmental law, statute, regulation or ordinance; claims for a violation of any other non-criminal federal, state or other governmental law, statute, regulation or

ordinance; and claims for retaliation under any law, statute, regulation or ordinance.

CLAIMS NOT SUBJECT TO ARBITRATIONThe only claims or disputes not subject to arbitration are as follows: any claim by an employee for benefits under a plan or program which provides its own binding arbitration

procedure; any statutory workers compensation claim; and unemployment insurance claims;

Your agreement to adhere to this Dispute Resolution Program does not prohibit you from pursuing an administrativeclaim with the National Labor Relations Board, any state or federal department of labor, the California Department of Fair Employment and Housing or the United States Equal Employment Opportunity Commission. This Agreement, does, however, preclude you from personally pursuing court action regarding any such claim.

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Additionally, nothing in this Agreement is intended to prevent either you or the Company from obtaining injunctive reliefin court to prevent irreparable harm pending the conclusion of any arbitration conducted hereunder and either of usmay apply to the appropriate state or federal court for a temporary restraining order, preliminary injunction, or otherinterim or conservatory relief, as necessary, without breach of this arbitration agreement and without abridgement of thepowers of the arbitrator.

The parties also agree that any arbitration between the employee and the Company is of their individual claim and thatany claim subject to arbitration will not be arbitrated on a collective or class-wide basis. However, this provision doesnot preclude employees from exercising their rights under the National Labor Relations Act to joining other employeesin a collective action to improve working conditions.

Also, any non-legal dispute is not subject to arbitration. Examples include disputes over a performance evaluation,issues with co-workers, or complaints about your work site or work assignment which do not allege a legal violation.

Neither the employee nor the Company has to submit the items listed under this “Claims Not Subject to Arbitration”caption to arbitration under this Program and may seek and obtain relief from a court or the appropriate administrativeagency.

REQUIRED NOTICE OF ALL CLAIMSWhen seeking arbitration, the claimant must file the Request for Arbitration form and give written notice of any claim to the other party within one year of the act complained of or within the applicable statute of limitations period, whichever is longer. Subject to any exceptions under applicable law, the day the act complained of occurred shall be counted for purposes of determining the applicable period.

Use the Request for Arbitration form when submitting a claim for arbitration. Identify and describe the nature of allclaims asserted and the facts on which your claims are based. Send this written notice by certified or registered mail,return receipt requested. If the Company wishes to invoke Arbitration, it will also complete a Request for Arbitrationform identifying and describing the nature of all claims asserted and the facts on which the claims are based and sendthis written notice to you at the last address recorded in the Company’s payroll records.

ARBITRATION PROCEDURESYou must use the Mediation Step explained in this policy before requesting Arbitration. The agency will administer anyArbitration under the AAA’s “National Rules for the Resolution of Employment Disputes” and in conformity with thisDispute Resolution Program. Go to ADR.org to obtain a copy of the rules or request a copy from the Company. Therules in effect on the date a demand is made shall control.

The arbitration will be before a neutral arbitrator who is licensed to practice law and who has significant experience in the employment law area. The arbitration shall apply the substantive law and the laws of remedies, if applicable, of thestate in which the claim arose, or federal law or both, depending upon the claims asserted. The decision of thearbitrator shall be in writing and shall provide the reasons for the award unless the parties agree otherwise.

The arbitrator shall have jurisdiction to hear and rule on pre-hearing disputes and is authorized to hold a pre-hearingconference by telephone or in person, as the arbitrator deems necessary. The arbitrator shall have the authority to ruleon a motion to dismiss and/or a motion for summary judgment by any party and, in doing so, must apply the standardsgoverning such motion under the Federal Rules of Civil Procedure.

PRE-HEARING PROCEDURESYou and the Company each have the right to take the deposition of individuals and expert witnesses designated byanother party. Depositions and other pre-trial discovery will be taken in accordance with the order of the arbitrator selected under the Program, who shall allow adequate discovery. You and the Company have the right to subpoena witnesses to the Arbitration in accordance with the Federal Rules of Civil Procedure. At least thirty (30) days before theArbitration, you and the Company must exchange lists of witnesses, including any experts, and copies of all exhibits tobe used at the Arbitration.

ARBITRATION FEES AND COSTSThere are two types of administrative fees and costs associated with Arbitration; a filing fee with the arbitration agencyselected and payment to the arbitrator for his or her services and expenses. Such fees and other expenses shall be allocated as follows:

1. The party requesting Arbitration must pay a $125.00 filing fee to the agency to request Arbitration. If you requestArbitration the Company will pay the balance of the initial filing fee, and will pay the entire fee if it requests Arbitration.2. Either party, at its expense, may arrange for and pay the cost of a court reporter to provide a stenographicrecord of the Arbitration proceedings.

CA-EE-HBK- 21 -

3. Each party shall be responsible for its own attorneys’ fees and related litigation expenses, if any; however, if anyparty prevails on a statutory claim, which allows the prevailing party to be awarded attorneys’ fees the arbitrator mayaward reasonable fees to the prevailing party.4. Where permitted by law, the arbitrator may assess attorneys’ fees against a party upon showing by the otherparty that the first party’s claim is frivolous or unreasonable or factually groundless.5. If either party pursues a legal claim covered by the Dispute Resolution Program in court or by any means otherthan Arbitration, the responding party shall be entitled to stay or dismissal of such action, the remand of such action to Arbitration, and the recovery of all costs and attorneys’ fees and expenses related to such action.

MULTI-STATE BUSINESSThe Company is engaged in transactions involving interstate commerce and your employment involves suchcommerce; therefore, the parties agree that the Federal Arbitration Act shall govern the interpretation, enforcement andproceedings under the Dispute Resolution Program.

PROGRAM PROVISIONS/ENFORCEMENTThe provisions of the Program document are severable and, should any provision be held unenforceable, all others will remain valid and binding. No provision of the Program document will be held unenforceable if such provision can be reasonably interpreted in a manner that results in such provision being enforceable. The arbitrators, and not anyfederal, state, or local court or agency, shall have exclusive authority to resolve any dispute relating to theinterpretation, arbitrability, applicability, enforceability or formation of the agreement to arbitrate including, but not limitedto, any claim that all or any part of the agreement to arbitrate is void and voidable.

If a court should determine that Arbitration under this Program is not the exclusive, final, and binding method for the Company and its employees to resolve disputes and/or that the decision and award of the arbitrator is not final andbinding as to some or all of a party’s claim(s), the party must submit the claim(s) to Arbitration and pursue theArbitration to conclusion before filing or pursuing any legal, equitable, or other legal proceeding for any eligible claim ina court of competent jurisdiction.

PROGRAM STEPSWhile we encourage you to use all of the steps in the Program in the order outlined, we realize that in some cases itmay not be appropriate to use the preliminary steps. Accordingly, if your claim involves a legal claim that is subject toArbitration hereunder, you may proceed directly to Step 3, Mediation, without first using Step 1, Open Door Policy or Step 2, Executive Review. The Company may skip Steps 1 and 2 if a legal claim is involved.

NOT AN EMPLOYMENT CONTRACT/EXCLUSIVE REMEDYWhile this Program constitutes a binding promise between you and the Company to resolve all disputes pursuant to theprocess outlined herein, this Program is not and shall not be construed to create any contract of employment, expressed or implied. Nor does this Program in any way alter the “at will” status of any employment.

This Program will prevent you from filing a lawsuit in Court for individual, class, or collective relief for a legal claim subject to arbitration.

[2004EDR Systems, LLC/All Rights Reserved/Revised 2011]

Apple American Group (Apple American Group LLC and Apple American Group II LLC) includes the following subsidiaries and affiliates:Apple Delaware LLC, Apple Indiana I LLC, Apple Indiana II LLC, Apple Indiana III LLC, Apple New Jersey LLC, Apple NorCal LLC,WineCountry Apple LLC, Apple Ohio LLC, Apple Pennsylvania LLC, B.T. Woodlipp, Inc, Apple Washington LLC, AppleSoCal LLC, AppleNevada LLC, Apple Minnesota LLC and Apple New England LLC

CA-EE-HBK- 22 -

CA-EE-HBK

For m

ore i

nfor

mat

ion,

cont

act D

FEH

toll

free

at

(800

) 884

-168

4Sa

cram

ento

are

a &

out

-of-

stat

e at (

916)

478

-720

0TT

Y nu

mbe

r at (

800)

700

-232

0or

visi

t our

Web

site

at w

ww.

dfeh

.ca.

gov

In a

ccor

danc

e with

the C

alifo

rnia

Gov

ernm

ent C

ode a

nd

AD

A re

quire

men

ts, th

is pu

blica

tion

can

be m

ade a

vaila

ble

in B

raill

e, la

rge p

rint,

com

pute

r disk

, or t

ape c

asse

tte a

s a

disa

bilit

y-re

late

d re

ason

able

acco

mm

odat

ion

for a

n in

divi

dual

with

a d

isabi

lity.

To d

iscus

s how

to re

ceiv

e a co

py

of th

is pu

blica

tion

in a

n al

tern

ativ

e for

mat

, plea

se co

ntac

t D

FEH

at t

he n

umbe

rs a

bove

.

Stat

e of

Cal

iforn

iaD

epar

tmen

t of F

air E

mpl

oym

ent &

Hou

sing

DFE

H-1

85 (1

1/07

)

The

defin

itio

n of

sex

ual h

aras

smen

t inc

lude

s

man

y fo

rms

of o

ffen

sive

beh

avio

r.

Dep

artm

ent o

f Fai

r Em

ploy

men

t and

Hou

sing

Sexu

al H

aras

smen

tTh

e Fa

cts A

bout

Sex

ual H

aras

smen

t

The

Fair

Empl

oym

ent a

nd H

ousin

g Ac

t (FE

HA

) de

fines

sexu

al h

aras

smen

t as h

aras

smen

t ba

sed

on se

x or

of a

sexu

al n

atur

e; g

ende

r ha

rass

men

t; an

d ha

rass

men

t bas

ed o

n pr

egna

n-cy

, chi

ldbi

rth,

or r

elat

ed m

edic

al c

ondi

tions

. Th

e defi

nitio

n of

sexu

al h

aras

smen

t inc

lude

s m

any

form

s of o

ffens

ive

beha

vior

, inc

ludi

ng

hara

ssm

ent o

f a p

erso

n of

the

sam

e ge

nder

as

the

hara

sser

. The

follo

win

g is

a pa

rtia

l list

of

type

s of s

exua

l har

assm

ent:

• U

nwan

ted

sexu

al a

dvan

ces

• O

fferin

g em

ploy

men

t ben

efits

in

exch

ange

for s

exua

l fav

ors

• A

ctua

l or t

hrea

tene

d re

talia

tion

• Le

erin

g; m

akin

g se

xual

ges

ture

s; or

di

spla

ying

sexu

ally

sugg

estiv

e ob

ject

s, pi

ctur

es, c

arto

ons,

or p

oste

rs

• M

akin

g or

usin

g de

roga

tory

com

men

ts,

epith

ets,

slurs

, or j

okes

• Se

xual

com

men

ts in

clud

ing

grap

hic

com

-m

ents

abo

ut a

n in

divi

dual

’s bo

dy; s

exu-

ally

deg

radi

ng w

ords

use

d to

des

crib

e an

indi

vidu

al; o

r sug

gest

ive o

r obs

cene

lette

rs,

note

s, or

invi

tatio

ns

• Ph

ysic

al to

uchi

ng o

r ass

ault,

as w

ell a

s im

pedi

ng o

r blo

ckin

g m

ovem

ents

such

as a

lead

, sup

ervi

sor,

man

ager

or a

gent

;

• th

e em

ploy

er h

ad n

o kn

owle

dge

of th

e

hara

ssm

ent;

• th

ere w

as a

prog

ram

to p

reve

nt h

aras

smen

t; an

d

• on

ce a

war

e of

any

har

assm

ent,

the

empl

oyer

to

ok im

med

iate

and

app

ropr

iate

cor

rect

ive

actio

n to

stop

the

hara

ssm

ent.

Filin

g a

Com

plai

nt

Empl

oyee

s or j

ob ap

plic

ants

who

bel

ieve

that

they

ha

ve b

een

sexu

ally

har

asse

d m

ay fi

le a

com

plai

nt o

f di

scrim

inat

ion

with

DFE

H w

ithin

one

yea

r of t

he

hara

ssm

ent.

DFE

H se

rves

as a

neu

tral

fact

-find

er a

nd a

ttem

pts t

o he

lp th

e pa

rtie

s vol

unta

rily

reso

lve

disp

utes

. If

DFE

H fi

nds s

ufficie

nt ev

iden

ce to

esta

blish

that

dis-

crim

inat

ion

occu

rred

and

settl

emen

t effo

rts f

ail,

the

Dep

artm

ent m

ay fi

le a f

orm

al ac

cusa

tion.

The a

ccus

a-tio

n w

ill le

ad to

eith

er a

publ

ic h

earin

g be

fore

the F

air

Empl

oym

ent a

nd H

ousin

g C

omm

issio

n or

a la

wsu

it fil

ed b

y D

FEH

on

beha

lf of

the c

ompl

aini

ng p

arty

.

If th

e C

omm

issio

n fin

ds th

at d

iscrim

inat

ion

has o

c-cu

rred

, it c

an o

rder

rem

edie

s inc

ludi

ng:

• Fi

nes o

r dam

ages

for e

mot

iona

l dist

ress

fr

om e

ach

empl

oyer

or p

erso

n fo

und

to h

ave

viol

ated

the

law

• H

iring

or r

eins

tate

men

t

• Ba

ck p

ay o

r pro

mot

ion

• C

hang

es in

the

polic

ies o

r pra

ctic

es o

f the

in

volv

ed e

mpl

oyer

Empl

oyee

s can

also

pur

sue

the

mat

ter t

hrou

gh

a pr

ivat

e la

wsu

it in

civ

il co

urt a

fter a

com

plai

nt

has b

een

filed

with

DFE

H a

nd a

Rig

ht-t

o-Su

e

Not

ice

has b

een

issue

d.

For m

ore

info

rmat

ion,

see

publ

icat

ion

DFE

H-1

59

“Gui

de fo

r Com

plai

nant

s and

Res

pond

ents

.”

CA-EE-HBK

The

mis

sion

of t

he D

epar

tmen

t of F

air E

mpl

oym

ent a

nd H

ousi

ng is

to p

rote

ct th

e pe

ople

of

Calif

orni

a fr

om u

nlaw

ful d

iscr

imin

atio

n in

em

ploy

men

t, h

ousi

ng a

nd p

ublic

acc

omm

odat

ions

, and

from

the

perp

etra

tion

of a

cts

of h

ate

viol

ence

.

Empl

oyer

s’ O

blig

atio

ns

All

empl

oyer

s mus

t tak

e th

e fo

llow

ing

actio

ns

agai

nst h

aras

smen

t:

• Ta

ke a

ll re

ason

able

step

s to

prev

ent

disc

rim

inat

ion

and

hara

ssm

ent f

rom

oc

curr

ing.

If h

aras

smen

t doe

s occ

ur,

take

effe

ctiv

e ac

tion

to st

op a

ny fu

rthe

r ha

rass

men

t and

to c

orre

ct a

ny e

ffect

s of

the

hara

ssm

ent.

• D

evel

op a

nd im

plem

ent a

sexu

al h

aras

s-m

ent p

reve

ntio

n po

licy

with

a p

roce

dure

fo

r em

ploy

ees t

o m

ake

com

plai

nts a

nd

for t

he em

ploy

er to

inve

stig

ate c

ompl

aint

s. Po

licie

s sho

uld

incl

ude

prov

ision

s to:

• Fu

lly in

form

the

com

plai

nant

of

his/

her r

ight

s and

any

obl

igat

ions

to se

-cu

re th

ose

right

s.

• Fu

lly a

nd e

ffect

ivel

y in

vest

igat

e. Th

e in

ves-

tigat

ion

mus

t be

thor

ough

, obj

ectiv

e, an

d co

mpl

ete.

Any

one w

ith in

form

atio

n re

-ga

rdin

g th

e m

atte

r sho

uld

be in

terv

iew

ed.

A d

eter

min

atio

n m

ust b

e m

ade

and

the

re-

sults

com

mun

icat

ed to

the

com

plai

nant

, to

the a

llege

d ha

rass

er an

d, as

appr

opria

te,

to al

l oth

ers d

irect

ly co

ncer

ned.

• Ta

ke p

rom

pt a

nd e

ffect

ive

corr

ectiv

e ac

tion

if th

e ha

rass

men

t alle

gatio

ns a

re

prov

en. Th

e em

ploy

er m

ust t

ake

appr

opri-

ate a

ctio

n to

stop

the h

aras

smen

t and

en-

sure

it w

ill n

ot c

ontin

ue. Th

e em

ploy

er

mus

t als

o co

mm

unic

ate

to th

e co

m-

plai

nant

that

actio

n ha

s bee

n ta

ken

to st

op th

e ha

rass

men

t fro

m re

curr

ing.

Fin

ally,

appr

opria

te

steps

mus

t be t

aken

to re

med

y the

com

plai

nant

’s da

mag

es, i

f any

.

• Po

st th

e D

epar

tmen

t of F

air E

mpl

oym

ent a

nd

Hou

sing

(DFE

H) e

mpl

oym

ent p

oste

r (D

FEH

- 1

62) i

n th

e w

orkp

lace

(ava

ilabl

e th

roug

h th

e D

FEH

pub

licat

ions

line

[916

] 478

-720

1 or

W

eb si

te).

• D

istrib

ute

an in

form

atio

n sh

eet o

n se

xual

ha

rass

men

t to

all e

mpl

oyee

s. A

n em

ploy

er m

ay

eith

er d

istrib

ute

this

pam

phle

t (D

FEH

185

) or

dev

elop

an

equi

vale

nt d

ocum

ent t

hat m

eets

th

e re

quire

men

ts o

f Gov

ernm

ent C

ode

sect

ion

1295

0(b)

. This

pam

phle

t may

be

dupl

icat

ed in

an

y qu

antit

y. H

owev

er, t

his p

amph

let i

s no

t to

be u

sed

in p

lace

of a

sexu

al h

aras

smen

t pr

even

tion

polic

y, w

hich

all

empl

oyer

s are

re

quir

ed to

hav

e.

• A

ll em

ploy

ees s

houl

d be

mad

e aw

are

of th

e se

rious

ness

of v

iola

tions

of t

he se

xual

har

assm

ent

polic

y an

d m

ust b

e cau

tione

d ag

ains

t usin

g pe

er

pres

sure

to d

iscou

rage

har

assm

ent v

ictim

s fr

om c

ompl

aini

ng.

• Em

ploy

ers w

ho d

o bu

sines

s in

Cal

iforn

ia a

nd

empl

oy 5

0 or

mor

e pa

rt-t

ime

or fu

ll-tim

e em

ploy

ees m

ust p

rovi

de a

t lea

st tw

o ho

urs o

f se

xual

har

assm

ent t

rain

ing

ever

y tw

o ye

ars

to e

ach

supe

rviso

ry e

mpl

oyee

and

to a

ll ne

w

supe

rviso

ry e

mpl

oyee

s with

in si

x m

onth

s of

thei

r ass

umpt

ion

of a

supe

rviso

ry p

ositi

on.

• A

pro

gram

to e

limin

ate

sexu

al h

aras

smen

t fro

m

the

wor

kpla

ce is

not

onl

y re

quire

d by

law,

but

is

the m

ost p

ract

ical

way

for a

n em

ploy

er

to a

void

or l

imit

liabi

lity

if ha

rass

men

t sho

uld

occu

r des

pite

pre

vent

ive

effor

ts.

Empl

oyer

Lia

bilit

y

All

empl

oyer

s, re

gard

less o

f the

num

ber o

f em

ploy

ees,

are c

over

ed b

y th

e har

assm

ent s

ectio

n of

the F

EHA

. Em

ploy

ers a

re g

ener

ally

liab

le fo

r har

assm

ent b

y th

eir s

uper

viso

rs o

r age

nts.

Har

asse

rs, i

nclu

ding

bot

h su

perv

isory

and

non

-sup

ervi

sory

per

sonn

el, m

ay b

e he

ld p

erso

nally

liab

le fo

r har

assi

ng a

n em

ploy

ee o

r co

wor

ker o

r for

aid

ing

and

abet

ting

hara

ssm

ent.

Add

ition

ally

, the

law

requ

ires

em

ploy

ers t

o ta

ke

“all

reas

onab

le st

eps t

o pr

even

t har

assm

ent f

rom

oc

curr

ing.

” If

an

empl

oyer

has

faile

d to

take

such

pr

even

tive

mea

sure

s, th

at e

mpl

oyer

can

be

held

li-

able

for t

he h

aras

smen

t. A

vic

tim m

ay b

e en

title

d to

da

mag

es, e

ven

thou

gh n

o em

ploy

men

t opp

ortu

nity

ha

s bee

n de

nied

and

ther

e is n

o ac

tual

loss

of p

ay o

r be

nefit

s.

In a

dditi

on, i

f an

empl

oyer

kno

ws o

r sho

uld

have

kn

own

that

a n

on-e

mpl

oyee

(e.g

. clie

nt o

r cus

tom

-er

) has

sexu

ally

har

asse

d an

em

ploy

ee, a

pplic

ant,

or

pers

on p

rovi

ding

serv

ices

for t

he em

ploy

er an

d fa

ils

to ta

ke im

med

iate

and

app

ropr

iate

cor

rect

ive

ac-

tion,

the

empl

oyer

may

be

held

liab

le fo

r the

act

ions

of

the

non-

empl

oyee

.

An

empl

oyer

mig

ht a

void

liab

ility

if

• th

e ha

rass

er is

not

in a

pos

ition

of a

utho

rity,

CA-EE-HBK

CA-EE-HBK

CA-EE-HBK

(Fol

d)(F

old)

(Fol

d)(F

old)

H

ow t

o C

laim

Sta

te P

lan

Ben

efi t

s

1. R

eque

st a

cla

im fo

rm:

• B

y te

leph

one:

1-8

00-4

80-3

287

• B

y In

tern

et: w

ww

.edd

.ca.

gov

• B

y TT

Y (t

elet

ypew

rite

r fo

r de

af, h

eari

ng-

impa

ired

and

spee

ch-im

paire

d pe

rson

s on

ly):

1-80

0-56

3-24

41 fo

r D

I or

1-8

00-4

45-1

312

for

PFL.

• B

y m

ail:

EDD

, Dis

abili

ty In

sura

nce,

P.

O. B

ox 1

3140

, Sac

ram

ento

, CA

958

13-3

140

• I

n pe

rson

by

visi

ting

any

of th

e D

I offi

ces

liste

d un

der “

Dis

abili

ty In

sura

nce

Offi

ce L

ocat

ions

.”

• C

alifo

rnia

Sta

te g

over

nmen

t em

ploy

ees

cove

red

by S

DI s

houl

d te

leph

one

1-86

6-35

2-76

75.

2. F

ill o

ut a

nd s

ign

the

“Cla

iman

t’s S

tate

men

t.”

Prin

t cle

arly

, and

be

sure

that

you

r ans

wer

s ar

e co

mpl

ete

and

corr

ect b

ecau

se e

rror

s m

ay

dela

y pa

ymen

ts.

3. H

ave

your

doc

tor

com

plet

e th

e “P

hysi

cian

/Pr

actit

ione

r’s C

ertifi

cat

e.”

Usu

ally

a c

laim

ca

nnot

beg

in m

ore

than

sev

en d

ays

befo

re

you

wer

e ex

amin

ed b

y or

und

er th

e ca

re o

f a

certi

fyin

g ph

ysic

ian/

prac

titio

ner.

Cer

tifi c

atio

n m

ay b

e m

ade

by a

lice

nsed

med

ical

or

oste

opat

hic

phys

icia

n an

d su

rgeo

n, n

urse

pr

actit

ione

r, ch

irop

ract

or, d

entis

t, po

diat

rist

, op

tom

etri

st, d

esig

nate

d ps

ycho

logi

st, o

r an

au

thor

ized

med

ical

offi

cer

of a

Uni

ted

Stat

es

Gov

ernm

ent f

acili

ty. C

ertifi

cat

ion

may

als

o be

m

ade

by a

lice

nsed

nur

se-m

idw

ife o

r lic

ense

d m

idw

ife fo

r di

sabi

litie

s re

late

d to

nor

mal

pr

egna

ncy

or c

hild

birt

h.

4. M

ail y

our

clai

m fo

rm w

ithin

49

days

from

th

e fi r

st d

ay y

ou w

ere

disa

bled

. If y

our

clai

m is

late

, you

may

lose

ben

efi ts

unl

ess

your

exp

lana

tion

of th

e de

lay

is a

ccep

ted

as

reas

onab

le.

How

Ben

efi t

s A

re P

aid

• T

he S

DI P

rogr

am is

des

igne

d to

ser

ve y

ou b

y m

ail o

r on

line.

You

do

not n

eed

to a

ppea

r in

pe

rson

to a

pply

for

or r

ecei

ve b

enefi

ts.

EDD

is a

n eq

ual o

ppor

tuni

ty e

mpl

oyer

/pro

gram

. A

uxili

ary

aids

and

ser

vice

s ar

e av

aila

ble

upon

req

uest

to in

divi

dual

s w

ith d

isab

ilitie

s. R

eque

sts

for

serv

ices

, ai

ds, a

nd/o

r al

tern

ate

form

ats

need

to b

e m

ade

by c

allin

g D

I at 1

-800

-480

-328

7 (v

oice

), or

TTY

1-

800-

563-

2441

, or

PFL

at 1

-877

-238

-437

3 or

TTY

1-

800-

445-

1312

.

This

pam

phl

et is

for

gene

ral i

nfo

rmat

ion

onl

y,

and

do

es n

ot

have

the

forc

e an

d e

ffec

t o

f the

law

, ru

le o

r re

gula

tio

n.

Dis

abili

ty is

any

illn

ess

or in

jury

, eith

er p

hysi

cal

or m

enta

l, th

at p

reve

nts

you

from

doi

ng y

our

regu

lar

or c

usto

mar

y w

ork.

Dis

abili

ty a

lso

incl

udes

el

ectiv

e su

rger

y, p

regn

ancy

, chi

ldbi

rth,

or

rela

ted

med

ical

con

ditio

ns.

Dis

abili

ty I

nsur

ance

(D

I) is

a c

ompo

nent

of t

he

Stat

e D

isab

ility

Insu

ranc

e (S

DI)

Prog

ram

and

is

des

igne

d to

par

tially

rep

lace

wag

es y

ou lo

st

beca

use

of a

dis

abili

ty th

at w

as n

ot c

ause

d by

yo

ur w

ork.

(See

“O

ther

Pro

gram

s” o

n re

vers

e fo

r jo

b-re

late

d di

sabi

litie

s.)

SDI t

axes

are

pai

d by

thos

e C

alifo

rnia

wor

kers

who

are

cov

ered

by

the

SDI p

rogr

am. T

ax

rate

s m

ay v

ary

from

yea

r to

yea

r. Fo

r cu

rren

t ra

tes,

con

tact

the

Empl

oym

ent D

evel

opm

ent

Dep

artm

ent (

EDD

) DI C

usto

mer

Ser

vice

at

1-80

0-48

0-32

87 o

r ED

D E

mpl

oym

ent T

ax

Cus

tom

er S

ervi

ce a

t 1-8

88-7

45-3

886.

DI

Plan

s

• S

tate

Pla

n. D

I’s s

tate

pla

n is

cov

ered

in th

is

broc

hure

.

• V

olun

tary

Pla

n. T

his

is a

priv

ate

plan

, app

rove

d by

the

Dire

ctor

of E

DD

, whi

ch m

ay b

e su

bstit

uted

fo

r th

e St

ate

Plan

. Em

ploy

ers

and

empl

oyee

gr

oups

may

est

ablis

h vo

lunt

ary

plan

s if

the

maj

ority

of e

mpl

oyee

s an

d th

e em

ploy

er a

gree

to

do

so. I

f you

are

cov

ered

by

a vo

lunt

ary

plan

, th

e pr

ovis

ions

of t

his

broc

hure

may

not

app

ly to

yo

u. O

btai

n in

form

atio

n ab

out y

our

cove

rage

an

d fi l

e a

volu

ntar

y pl

an c

laim

thro

ugh

your

em

ploy

er.

• E

lect

ive

Cov

erag

e. E

mpl

oyer

s an

d se

lf-em

ploy

ed

pers

ons,

incl

udin

g ge

nera

l par

tner

s, m

ay e

lect

co

vera

ge. H

owev

er, t

he m

etho

d of

com

putin

g be

nefi t

s fo

r el

ectiv

e co

vera

ge p

artic

ipan

ts is

not

th

e sa

me

as fo

r m

anda

tory

rat

e pa

yers

. The

cos

t of

par

ticip

atin

g, w

hich

is s

et a

nnua

lly, c

an b

e ob

tain

ed fr

om y

our

loca

l ED

D E

mpl

oym

ent T

ax

Cus

tom

er S

ervi

ce O

ffi ce

.

Elec

tive

Cov

erag

e cl

aim

s ar

e fi l

ed in

the

sam

e m

anne

r as

Sta

te P

lan

clai

ms;

how

ever

, th

ere

are

som

e di

ffere

nces

in e

ligib

ility

re

quir

emen

ts fr

om th

ose

liste

d in

this

pam

phle

t. Fo

r ad

ditio

nal i

nfor

mat

ion

or to

app

ly fo

r co

vera

ge, c

onta

ct E

DD

DI C

usto

mer

Ser

vice

at

1-8

00-4

80-3

287

or E

DD

Em

ploy

men

t Tax

C

usto

mer

Ser

vice

at 1

-888

-745

-388

6.

DIS

AB

ILIT

YIN

SUR

AN

CE

PRO

VIS

ION

S

DE

2515

Rev

. 59

(1-1

2) (

INTE

RN

ET)

Pag

e 1

of 2

C

U

DI

Cla

im M

anag

emen

t O

ffi c

es

Ala

med

a ....

.160

0 H

arbo

r B

ay P

arkw

ay, S

te. 1

20(w

rite

to: P

O B

ox 1

857,

Oak

land

, CA

946

04-1

857)

Chi

co ..

......

......

......

......

......

.....

645

Sale

m S

tree

t(w

rite

to: P

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ox 8

190,

Chi

co, C

A 9

5927

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Chi

no H

ills .

.153

15 F

airfi

eld

Ranc

h Ro

ad, S

te. 1

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rite

to: P

O B

ox 6

0006

, City

of I

ndus

try,

CA

917

16-0

006)

Fres

no ..

......

...25

50 M

arip

osa

Mal

l, R

m. 1

080A

(wri

te to

: PO

Box

32,

Fre

sno,

CA

937

07-0

032)

Long

Bea

ch ..

.430

0 Lo

ng B

each

Blv

d., S

te. 6

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rite

to: P

O B

ox 4

69, L

ong

Bea

ch, C

A 9

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9)

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eles

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S. F

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et, S

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to: P

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6

N. L

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154

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eet

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te to

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Box

781

, San

Ber

nard

ino,

CA

924

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781)

San

Die

go ..

9246

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htw

ave

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ue, B

ldg.

A, S

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rite

to: P

O B

ox 1

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an D

iego

, CA

921

12-0

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San

Fran

cisc

o ...

....7

45 F

rank

lin S

tree

t, R

m. 3

00(w

rite

to: P

O B

ox 1

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4, S

an F

ranc

isco

, CA

941

19-3

534)

San

Jose

.....

......

......

....

297

Wes

t Hed

ding

Str

eet

(wri

te to

: PO

Box

637

, San

Jose

, CA

951

06-0

637)

Sant

a A

na ..

605

Wes

t San

ta A

na B

lvd.,

Bldg

. 28,

Rm

. 735

(wri

te to

: PO

Box

146

6, S

anta

Ana

, CA

927

02-1

466)

Sant

a B

arba

ra ..

......

......

...12

8 Ea

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a St

reet

(wri

te to

: PO

Box

152

9, S

anta

Bar

bara

, CA

931

02-1

529)

Sant

a R

osa .

......

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......

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Ave

nue

(wri

te to

: PO

Box

700

, San

ta R

osa,

CA

954

02-0

700)

Stoc

kton

.....

......

......

..52

8 N

orth

Mad

ison

Str

eet

(wri

te to

: PO

Box

201

006,

Sto

ckto

n, C

A 9

5201

-900

6)

CA-EE-HBK

(Fol

d)(F

old)

(Fol

d)(F

old)

• W

hen

your

cla

im is

rec

eive

d, y

ou m

ay

be c

onta

cted

by

mai

l or

by te

leph

one

for

addi

tiona

l inf

orm

atio

n if

need

ed. M

ost c

laim

s ar

e pr

oces

sed

with

in 1

4 da

ys.

• T

he fi

rst s

even

day

s of

you

r di

sabi

lity

clai

m

are

a “n

on p

ayab

le”

wai

ting

peri

od.

Ben

efi ts

are

pai

d as

qui

ckly

as

poss

ible

afte

r al

l in

form

atio

n to

det

erm

ine

elig

ibili

ty is

rec

eive

d.

If yo

u m

eet a

ll el

igib

ility

req

uire

men

ts, b

enefi

ts

will

be

auth

oriz

ed. I

f you

are

elig

ible

for

furt

her

bene

fi ts,

you

will

be

sent

add

ition

al b

enefi

ts

auto

mat

ical

ly o

r se

nt a

“co

ntin

ued

clai

m”

cert

ifi ca

tion

form

for

you

to c

ompl

ete

for

the

next

ben

efi t

perio

d. U

sual

ly th

ese

bene

fi t p

erio

ds

will

be

in tw

o w

eek

inte

rval

s. H

owev

er, t

he D

I pr

ogra

m p

ays

bene

fi ts

base

d on

dai

ly e

ligib

ility

w

ithin

a s

even

-day

cal

enda

r w

eek.

Par

tial w

eeks

ar

e pa

id a

t a d

aily

rat

e. T

his

rate

is o

ne-s

even

th

of y

our

wee

kly

bene

fi t a

mou

nt. P

leas

e al

low

ten

days

from

the

date

you

mai

l a c

ertifi

cat

ion

for

rece

ipt o

f you

r pa

ymen

t.

How

You

r B

enefi

t R

ate

is D

eter

min

ed

Your

ben

efi t

amou

nts

are

base

d on

wag

es p

aid

to y

ou d

urin

g a

spec

ifi c

12-m

onth

bas

e pe

riod

, w

hich

is d

eter

min

ed b

y th

e da

te y

our

clai

m

begi

ns. T

here

fore

, you

sho

uld

care

fully

con

side

r w

hen

to s

tart

you

r cl

aim

sin

ce th

is m

ay a

ffect

yo

ur w

eekl

y be

nefi t

rat

e, y

our

max

imum

ben

efi t

amou

nt, a

nd th

e pe

riod

of y

our b

enefi

t el

igib

ility

.

Onl

y th

e w

ages

in y

our

base

per

iod

that

wer

e su

bjec

t to

the

disa

bilit

y in

sura

nce

tax

can

be

used

in c

ompu

ting

your

ben

efi ts

. To

qual

ify, y

ou

mus

t hav

e ea

rned

at l

east

$30

0 du

ring

you

r ba

se

peri

od. T

he m

onth

in w

hich

you

r cl

aim

beg

ins

dete

rmin

es w

hich

four

con

secu

tive

quar

ters

m

ust b

e us

ed.

If yo

ur c

laim

beg

ins

in:

• J

anua

ry, F

ebru

ary,

or

Mar

ch, y

our

base

pe

riod

is t

he 1

2 m

onth

s en

ding

last

Se

ptem

ber

30. (

Exam

ple:

A c

laim

beg

inni

ng

Febr

uary

14,

201

1, u

ses

a ba

se p

erio

d of

O

ctob

er 1

, 200

9, th

roug

h Se

ptem

ber

30,

2010

.)

• A

pril,

May

, or

June

, you

r ba

se p

erio

d is

the

12

mon

ths

endi

ng la

st D

ecem

ber

31.

(Exa

mpl

e: A

cla

im b

egin

ning

June

20,

201

1,

uses

a b

ase

peri

od o

f Jan

uary

1, 2

009,

thro

ugh

Dec

embe

r 31

, 201

0.)

• J

uly,

Aug

ust,

or

Sept

embe

r, yo

ur b

ase

peri

od is

th

e 12

mon

ths

endi

ng la

st M

arch

31.

(Exa

mpl

e: A

cla

im b

egin

ning

Sep

tem

ber

27, 2

011,

us

es a

bas

e pe

riod

of A

pril

1, 2

010,

thro

ugh

Mar

ch 3

1, 2

011.

)•

Oct

ober

, Nov

embe

r, or

Dec

embe

r, yo

ur b

ase

peri

od is

the

12

mon

ths

endi

ng la

st Ju

ne 3

0.

(Exa

mpl

e: A

cla

im b

egin

ning

Nov

embe

r 2,

201

1,

uses

a b

ase

peri

od o

f Jul

y 1,

201

0, th

roug

hJu

ne 3

0, 2

011.

)

Exce

ptio

ns: I

f you

r cla

im is

det

erm

ined

to b

e in

valid

, bu

t you

wer

e un

empl

oyed

and

see

king

wor

k fo

r 60

days

or

mor

e in

any

qua

rter o

f you

r bas

e pe

riod,

you

may

be

abl

e to

sub

stitu

te w

ages

pai

d in

prio

r qua

rters

.

In a

dditi

on, y

ou m

ay b

e en

title

d to

sub

stitu

te w

ages

pa

id in

pri

or q

uart

ers

eith

er to

mak

e yo

ur c

laim

val

id

or to

incr

ease

you

r be

nefi t

am

ount

, if d

urin

g yo

ur

base

per

iod

you:

• w

ere

in th

e m

ilita

ry s

ervi

ce.

• r

ecei

ved

Wor

kers

’ Com

pens

atio

n be

nefi t

s.•

did

not

wor

k be

caus

e of

a la

bor

disp

ute.

If yo

ur s

ituat

ion

fi ts

any

of th

e ab

ove,

incl

ude

a no

te

with

you

r cl

aim

form

.

Wag

e C

onti

nuat

ion.

If y

our

empl

oyer

con

tinue

s to

pay

you

wag

es w

hile

you

are

dis

able

d, y

our

DI

bene

fi ts

may

be

affe

cted

. DI b

enefi

ts p

lus

wag

es

cann

ot e

xcee

d yo

ur r

egul

ar w

eekl

y w

age.

You

r D

I be

nefi t

s w

ill n

ot b

e af

fect

ed b

y an

y va

catio

n pa

y yo

u m

ay r

ecei

ve.

Max

imum

Ben

efi t

s. T

he m

axim

um b

enefi

t am

ount

is

52

times

the

wee

kly

rate

, but

not

mor

e th

an y

our

tota

l bas

e pe

riod

wag

es. E

xcep

tion:

For

em

ploy

ers

and

self-

empl

oyed

indi

vidu

als

who

ele

ct S

DI

cove

rage

, the

max

imum

ben

efi t

amou

nt is

39

times

th

e w

eekl

y ra

te.

In a

dditi

on, b

enefi

ts a

re p

ayab

le o

nly

for

a lim

ited

peri

od to

a r

esid

ent i

n an

alc

ohol

ic r

ecov

ery

hom

e or

dru

g-fr

ee r

esid

entia

l fac

ility

that

is b

oth

licen

sed

and

cert

ifi ed

by

the

stat

e in

whi

ch th

e fa

cilit

y is

loca

ted.

How

ever

, dis

abili

ties

rela

ted

to o

r cau

sed

by a

cute

or

chro

nic

alco

holis

m o

r dr

ug a

buse

, be

ing

med

ical

ly tr

eate

d, d

o no

t hav

e th

is li

mita

tion.

Preg

nanc

y. A

s w

ith a

ny m

edic

al c

ondi

tion,

you

r di

sabi

lity

perio

d be

gins

the

fi rst

day

you

are

una

ble

to d

o yo

ur re

gula

r or c

usto

mar

y w

ork.

DI b

enefi

ts

are

base

d on

the

perio

d of

tim

e yo

ur p

hysi

cian

/pr

actit

ione

r cer

tifi e

s yo

u ar

e un

able

to d

o yo

ur re

gula

r or

cus

tom

ary

wor

k. D

o N

OT

send

in y

our c

laim

for

preg

nanc

y-re

late

d di

sabi

lity

bene

fi ts

until

the

date

yo

ur p

hysi

cian

/pra

ctiti

oner

cer

tifi e

s yo

u ar

e di

sabl

ed.

NO

TE: F

or in

form

atio

n on

Pai

d Fa

mily

Lea

ve

bond

ing

bene

fi ts,

see

the

“Oth

er P

rogr

ams”

sec

tion

of th

is b

roch

ure.

You

May

Not

be

Elig

ible

for

Ben

efi t

s

• I

f you

are

rec

eivi

ng U

nem

ploy

men

tIn

sura

nce

or P

aid

Fam

ily L

eave

ben

efi ts

.•

If y

ou a

re n

ot w

orki

ng o

r lo

okin

g fo

r w

ork

at th

e tim

e yo

u be

com

e di

sabl

ed.

• I

f you

are

in c

usto

dy d

ue to

con

vict

ion

of a

cr

ime.

• I

f you

r fu

ll w

ages

are

pai

d.•

If y

ou a

re r

ecei

ving

Wor

kers

’ Com

pens

atio

n at

a

wee

kly

rate

equ

al to

or

grea

ter

than

the

DI r

ate.

If

Wor

kers

’ Com

pens

atio

n be

nefi t

s ar

e pa

id a

t a

low

er r

ate

than

you

r D

I rat

e, y

ou m

ay b

e pa

id

the

diffe

renc

e.•

For

the

amou

nt o

f tim

e a

clai

m is

late

(with

out

good

cau

se).

• I

f you

mak

e a

fals

e st

atem

ent o

r fai

l to

repo

rt

a m

ater

ial f

act.

(A 3

0 pe

rcen

t pen

alty

may

be

asse

ssed

if b

enefi

ts a

re o

verp

aid

beca

use

you

will

fully

with

held

a m

ater

ial f

act o

r mad

e a

fals

e st

atem

ent.)

• I

f you

fail

to a

ttend

an

inde

pend

ent m

edic

al

exam

inat

ion

whe

n re

ques

ted.

(Fee

s fo

r su

ch

exam

inat

ions

are

pai

d by

ED

D.)

The

Cal

iforn

ia U

nem

ploy

men

t Ins

uran

ce

Cod

e pr

ovid

es fo

r pen

altie

s co

nsis

ting

of fi

nes,

im

pris

onm

ent,

and

loss

of b

enefi

t ri

ghts

for

frau

d ag

ains

t the

DI s

yste

m.

Your

Rig

hts.

You

are

ent

itled

to:

• K

now

the

reas

on a

nd b

asis

for

any

deci

sion

that

af

fect

s yo

ur b

enefi

ts.

• A

ppea

l any

dec

isio

n ab

out y

our

elig

ibili

ty fo

r be

nefi t

s. (A

ppea

ls m

ust b

e se

nt to

the

DI o

ffi ce

in

wri

ting.

)•

A h

earin

g of

you

r app

eal b

efor

e an

Adm

inis

trativ

e La

w Ju

dge

(ALJ

). Yo

u m

ay fu

rther

app

eal t

he

ALJ

’s d

ecis

ion

to th

e C

alifo

rnia

Une

mpl

oym

ent

Insu

ranc

e A

ppea

ls B

oard

and

the

cour

ts.

• P

rivac

y. In

form

atio

n ab

out y

our

clai

m w

ill b

e ke

pt c

onfi d

entia

l exc

ept f

or th

e pu

rpos

es a

llow

ed

by la

w.

Your

Obl

igat

ions

. You

are

res

pons

ible

to:

• C

ompl

ete

your

cla

im a

nd o

ther

form

s co

rrec

tly,

com

plet

ely,

and

trut

hful

ly.

• M

ail y

our

clai

m a

nd o

ther

form

s in

the

time

limits

sho

wn

on th

e fo

rms.

If y

ou a

re la

te a

nd y

ou

belie

ve y

ou h

ave

a go

od r

easo

n fo

r be

ing

late

, yo

u sh

ould

incl

ude

a w

ritte

n ex

plan

atio

n of

the

reas

on(s

) with

the

form

.•

Con

tact

DI i

f you

do

not u

nder

stan

d a

ques

tion

or h

ow to

ans

wer

it.

• I

nclu

de y

our

nam

e an

d So

cial

Sec

urity

num

ber

on a

ll le

tters

to D

I.

Con

tact

DI

• B

y te

leph

one:

1-8

00-4

80-3

287

(Eng

lish)

or

1-86

6-65

8-88

46 (S

pani

sh).

• B

y U

.S. m

ail:

addr

esse

d to

the

offi c

e ha

ndlin

g yo

ur c

laim

and

on

the

Inte

rnet

at h

ttp:

//w

ww

.edd

.ca.

gov/

Dis

abili

ty/C

onta

ct_S

DI.

htm

#byl

ocat

ion.

If y

ou d

o no

t hav

e a

curr

ent

clai

m, y

ou m

ay w

rite

to a

ny D

I Cla

im

Man

agem

ent O

ffi ce

.•

By

TTY

(tel

etyp

ewrit

er fo

r dea

f, he

arin

g-im

paire

d,

and

spee

ch-i

mpa

ired

per

sons

onl

y):

1-80

0-56

3-24

41.

• B

y In

tern

et:

ht

tp://

ww

w.e

dd.c

a.go

v/A

bout

_ED

D/C

onta

ct_E

DD

.htm

• I

n pe

rson

by

visi

ting

any

of th

e D

I offi

ces

liste

d un

der

“Dis

abili

ty In

sura

nce

Offi

ce L

ocat

ions

.”

Oth

er P

rogr

ams

IF Y

OU

AR

E IN

JUR

ED O

N T

HE

JOB

or

beco

me

ill a

s a

resu

lt of

you

r oc

cupa

tion,

not

ify y

our

empl

oyer

.

IF Y

OU

AR

E A

BLE

AN

D A

VA

ILA

BLE

TO

WO

RK

bu

t une

mpl

oyed

, con

tact

the

Une

mpl

oym

ent

Insu

ranc

e Pr

ogra

m o

f ED

D a

t 1-8

00-3

00-5

616

(TTY

1-8

00-8

15-9

387)

.

IF Y

OU

NEE

D H

ELP

IN F

IND

ING

WO

RK

, JO

B

TRA

ININ

G, R

ETR

AIN

ING

, or

othe

r se

rvic

es in

or

der

to r

etur

n to

wor

k, v

isit

your

loca

l one

-st

op c

aree

r ce

nter

list

ed in

the

whi

te p

ages

of

your

tele

phon

e di

rect

ory

and

on th

e In

tern

et a

t: w

ww

.ser

vice

loca

tor.o

rg

IF Y

OU

R D

ISA

BIL

ITY

IS

PER

MA

NEN

T or

is

expe

cted

to c

ontin

ue fo

r a

year

or

mor

e, c

onta

ct

the

U.S

. Soc

ial S

ecur

ity A

dmin

istr

atio

n at

1-

800-

772-

1213

(TT

Y 1

-800

-325

-077

8) o

r on

th

e In

tern

et a

t: w

ww

.ssa

.gov

IF A

FA

MIL

Y M

EMB

ER T

AK

ES T

IME

OFF

FR

OM

W

OR

K T

O C

AR

E FO

R Y

OU

, con

tact

ED

D’s

Paid

Fa

mily

Lea

ve p

rogr

am a

t 1-8

77-2

38-4

373.

IF Y

OU

TA

KE

TIM

E O

FF F

RO

M W

OR

K T

O

BO

ND

WIT

H A

NEW

CH

ILD

, inc

ludi

ng n

ewly

ad

opte

d or

new

ly p

lace

d fo

ster

chi

ldre

n or

thos

e of

you

r re

gist

ered

dom

estic

par

tner

, con

tact

ED

D’s

Paid

Fam

ily L

eave

pro

gram

at

1-87

7-23

8-43

73 o

r TTY

1-8

00-4

45-1

312.

NO

TE: A

Pai

d Fa

mily

Lea

ve b

ondi

ng c

laim

form

w

ill b

e se

nt a

utom

atic

ally

with

the

fi nal

ben

efi t

paym

ent t

o ne

w m

othe

rs r

ecei

ving

DI b

enefi

ts.

IF Y

OU

AR

E A

VIC

TIM

OF

A C

RIM

E, c

all t

he

Cal

iforn

ia V

ictim

s C

ompe

nsat

ion

Prog

ram

at

1-80

0-77

7-92

29. T

TY u

sers

may

con

tact

the

Prog

ram

via

TTY

at

1-80

0-73

5-29

29 (

Engl

ish)

or

TTY

at

1-80

0-85

5-30

00 (

Span

ish)

. You

may

als

o co

ntac

t you

r co

unty

Vic

tim/W

itnes

s A

ssis

tanc

e C

ente

r.

QU

ESTI

ON

S A

BO

UT

SPO

USA

L O

R P

AR

ENTA

L SU

PPO

RT o

blig

atio

ns s

houl

d be

dir

ecte

d to

th

e D

istr

ict A

ttorn

ey’s

Offi

ce fo

r th

e co

unty

that

is

sued

the

cour

t ord

er.

QU

ESTI

ON

S A

BO

UT

CH

ILD

SU

PPO

RT

oblig

atio

ns s

houl

d be

dir

ecte

d to

the

Dep

artm

ent o

f Chi

ld S

uppo

rt S

ervi

ces

at

1-86

6-24

9-07

73.

DE

2515

Rev

. 59

(1-1

2) (

INTE

RN

ET)

Pag

e 2

of 2

C

U