Employer Account No.
Employer to Complete:
FED ID #
To be returned to:
Employment Development Department
Taxpayer Assistance Center, Attn: Specialized Coverage Desk
P.O. Box 2068
Rancho Cordova, CA 95741-2068
SELECTION OF FINANCING METHOD BY A NONPROFIT ORGANIZATION DESCRIBED IN
SECTION 501(c)(3) OF THE INTERNAL REVENUE CODE
Services performed in the employ of certain nonprofit organizations are subject to the compulsory provisions of the
California Unemployment Insurance Code (CUIC) for both unemployment and State disability insurance purposes.
The CUIC provides that nonprofit organizations exempt from federal income tax under Section 501(a) as an organization
described in Section 501(c)(3) of the Internal Revenue Code may elect to reimburse the Unemployment Insurance Fund for the
cost of benefits paid, rather than be assigned a tax rate and paying under the contribution rate method.
Have you been issued a ruling by the Internal Revenue Service exempting you from federal taxes as a nonprofit
If you answered “yes,” please enter the section of the Internal Revenue Code under which your exemption is issued:
Section: of the Internal Revenue Code
Attach a copy of your exemption letter. If exemption letter is being applied for, attach copy of Internal Revenue
Service Form 1023, Application for Recognition of Exemption Under Section 501(c)(3). Send copy of exemption
letter to above address when received from the Internal Revenue Service. Failure to submit a copy of your IRS
exemption letter within 6 months will result in a retroactive change of financing to the tax rate method and an
assessment for unemployment insurance contributions due for past quar