Beginning August 2011, State Fund will send payments to only one remittance address per Tax Identification Number (TIN).
If your company bills State Fund from multiple billing addresses, including through third-party billers, State Fund will send payments to only the tax-reporting address on your IRS Form W-9 (or State Fund’s equivalent SCIF Form 5159) rather than sending payments to multiple addresses. If you wish to use a remittance address separate from your tax-reporting address, you must specify that address on SCIF Form 5159.
Different from Tax-Reporting Address
If you prefer a remittance address different from your tax-reporting address, please fill out completely a SCIF Form 5159 “Request For Taxpayer Identification Number and Certification” to specify the remittance address that State Fund will use for your company.
Download a blank SCIF Form 5159 here.
A blank IRS Form W-9 is available here.
Download a blank SCIF Form 590 here.
Return the completed and signed form(s) via e-mail to email@example.com or via fax to 559-433-4533. (The e-mail address and fax number are for tax forms only, not bills.) Please allow 6 to 8 weeks for processing.
Same as Tax-Reporting Address
If you agree to have your tax-reporting address as your remittance address, you do not have to do anything. (However, you may fill out and submit the form(s) if you want to update your tax information in our records.)