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EPARTMENT Taxpayer Assistance Center, Attn: Specialized Coverage Desk PO BOX 2068 RANCHO CORDOVA, 95741-2068 (916) 654-6288 Fax (916) 464-2904 www.edd.ca.gov REGISTRATION FORM FOR GOVERNMENTAL ORGANIZATIONS, PUBLIC SCHOOLS, & INDIAN TRIBES See reverse for registration instructions for other business types. EDD ACCOUNT NUMBER QUARTER Dept. Use Only: A. LIST ALL PRINCIPAL OFFICERS OR ADMINISTRATORS TITLE SOCIAL SECURITY # C. DATE OWNERSHIP BEGAN OPERATING: MM DD YYYY B. BUSINESS NAME: (If.

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