How do I fill out a payee data record?

Complete name, title, e-mail address, telephone number, date, and handwritten or electronic signature of the payee's authorized representative. This signature certifies the accuracy of the information provided. All data on the submitted STD 204 must be unalterable including the signature.

What is a payee data record?

A completed Payee Data Record, STD 204 form, is required for all payees (non-governmental entities or individuals) entering into a transaction that may lead to a payment from the state.

What is the payee data record for STD 204?

Both state and federal laws require that all reportable payments be identified and reported in the Payee Data Record (STD. 204) form. This includes any state department that participates in a transaction resulting in a payment to any individual or entity that is not a governmental entity.

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Exhibit 5 PAYEE DATA RECORD - Department Of Housing And ... - Hcd Ca

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Exhibit 5 State of California Department of Health Services PAYEE DATA RECORD (Required when receiving payment from the State of California in lieu of IRS W-9) STD. 204 (Rev. 6-2003) 1 INSTRUCTIONS:.

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