In lieu of IRS W-9) DS 5860 (New 06/2015) 1 Reset Form INSTRUCTIONS: Complete all information on this form. Sign, date, and return to the State agency (department/office) address shown at the bottom of this page. Prompt return of this fully completed form will prevent delays when processing payments. Information provided in this form will be used by State agencies to prepare Information Returns (1099). See reverse side for more information and Privacy Statement. NOTE: Governmental entities,.

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How to fill out the CA DS 5860 online

Filling out the CA DS 5860 form is essential for individuals and entities receiving payments from the State of California. This guide provides clear and actionable steps to complete the form accurately to ensure timely payment processing.

Follow the steps to successfully complete the CA DS 5860 online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Enter the payee's legal business name in the appropriate field. If you are a sole proprietor, also include your full name as it appears on your Social Security Number documentation.
  3. Indicate the payee entity type by selecting one box that corresponds to your business status, such as sole proprietor, partnership, corporation, or estate. Ensure only one box is checked.
  4. Provide the email address and facility name, followed by the National Provider Identification number (NPI) and location number in the specified fields.
  5. Fill in both the facility address and the mailing address where payments and correspondence will be sent. Ensure that the city, state, and ZIP code are accurately entered.
  6. Enter your Federal Employer Identification Number (FEIN) or Social Security Number (SSN), as required for tax identification purposes. Remember that payment will not be processed without this information.
  7. Specify your residency status by indicating whether you are a California resident or nonresident. Provide any additional information as necessary regarding withholding for nonresidents.
  8. In the certification section, provide the name of the authorized payee representative, their title, and signature. Also, include their telephone number and the date the form is completed.
  9. Review all information for accuracy and completeness before final submission. Save changes, download, print, or share the form as needed.

Complete your CA DS 5860 form online to facilitate timely processing of your payments.

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What does the California Department of Developmental Services do?

The California Department of Developmental Services (DDS) works to ensure Californians with developmental disabilities have the opportunity to make choices and lead independent, productive lives as members of their communities in the least restrictive setting possible.

The California state disability protection and advocacy (P&A) agency is Disability Rights California (DRC). DRC is part of the nation's federally-funded P&A system.

Home - CA Department of Developmental Services.

​​Persons with Disabilities Assisted Living Waiver (ALW) Genetically Handicapped Persons Program. Developmentally Disabled-Continuous Nursing Care (DD) In-Home Supportive Services Plus (IHSS-Plus) Waiver.

California State Council on Developmental Disabilities (SCDD) The State Council on Developmental Disabilities (SCDD) is established by state and federal law as an independent state agency to ensure that people with developmental disabilities and their families receive the services and supports they need.

California Department of Developmental Services (CDDS) is the agency through which the State of California provides services and supports to individuals with developmental disabilities. These disabilities include intellectual disability, cerebral palsy, epilepsy, autism and related conditions.

The DS Task Force provides guidance on the delivery of services to Californians who have intellectual and developmental disabilities. Forty-two individuals will serve on the Task Force, and an additional 115 people will serve on the Task Force's five workgroups.

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