DS 5860 - California Department of Developmental Services - State ... - dds ca-2026

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The document is a Payee Data Record (DS 5860) required by the State of California's Department of Developmental Services for non-governmental entities receiving payments. It outlines the necessary information to be completed, including legal business name, entity type, taxpayer identification number, residency status, and certification of accuracy. The form is essential for processing payments and ensuring compliance with tax regulations.

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Click ‘Get Form’ to open the DS 5860 in the editor.
Begin by entering the Payee’s Legal Business Name. Ensure that sole proprietors include their full name as shown on their Social Security Number (SSN).
Select the appropriate Payee Entity Type by checking one box only. Options include Sole Proprietor, Partnership, Corporation, Estate or Trust, and Exempt (nonprofit).
Fill in your email address, facility name, NPI/LOC#, and both facility and mailing addresses. Make sure all information is accurate to avoid payment delays.
Indicate your Federal Employer Identification Number (FEIN) or Social Security Number (SSN) as required. Remember that payments will not be processed without this information.
Complete the residency status section by selecting whether you are a California resident or nonresident. This affects tax withholding requirements.
Finally, certify the information by providing your name, title, signature, telephone number, and date before submitting it to the specified State agency address.

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What does the California Department of Developmental Services do?

We are dedicated to providing services and supports for Californians with intellectual and developmental disabilities and their families to live the life of their choosing in their communities.

What services does the regional center provide in California?

Regional centers may offer: Information and referral. Counseling. Lifelong individualized planning and service coordination. Purchase of necessary services included in the Individual Program Plan (IPP) Resource development. OutdocHub to the community. Assistance in finding and using community and other resources.

What is DDS California?

The California Department of Developmental Services is the agency through which the State of California provides services and supports to individuals with developmental disabilities.

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What does DDS stand for in California?

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.

What services does DDA offer?

Types of DDA Services Individual Support Services (ISS) Individual Support Services focus on providing personalized assistance to individuals with developmental disabilities. Residential Services. Employment Services. Day Programs. Family Support Services.

What counts as a developmental disability?

Some examples of more common developmental disabilities include; ADHD, Autism Spectrum Disorders, Cerebral Palsy, intellectual disabilities and vision impairment.

DS 5860 - California Department of Developmental Services - State ... - dds ca-2026

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