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

1. Click ‘Get Form’ to open the DS 5860 in the editor.
2. 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).
3. Select the appropriate Payee Entity Type by checking one box only. Options include Sole Proprietor, Partnership, Corporation, Estate or Trust, and Exempt (nonprofit).
4. 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.
5. Indicate your Federal Employer Identification Number (FEIN) or Social Security Number (SSN) as required. Remember that payments will not be processed without this information.
6. Complete the residency status section by selecting whether you are a California resident or nonresident. This affects tax withholding requirements.
7. 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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