05._STD_205_Payee_Data_Record_Supp.pdf

The document is a State of California State Controller's Office Payee Data Record Supplement (STD 205) form, which is an optional supplemental document used to provide additional remittance address and contact information for payees beyond what is included on the standard STD 204 form. The form allows businesses or individuals to list up to five alternative remittance addresses and three additional authorized representatives for payment and tax reporting purposes.

The form is designed to facilitate tax compliance and payment processing for state business transactions, with specific requirements for providing a Taxpayer Identification Number (TIN) and matching payee information. It includes mandatory disclosure statements noting that furnishing the requested information is required by law, with potential penalties for non-compliance, including federal backup withholding and state noncompliance penalties of up to $20,000. The form emphasizes that 1099 information returns will be sent to the mailing address on the most recently validated STD 204, while addresses on the STD 205 are solely for remittance purposes.