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Get Ca Ds 5860 2015-2025
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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.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- 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.
- 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.
- Provide the email address and facility name, followed by the National Provider Identification number (NPI) and location number in the specified fields.
- 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.
- 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.
- Specify your residency status by indicating whether you are a California resident or nonresident. Provide any additional information as necessary regarding withholding for nonresidents.
- 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.
- 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.
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.
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