Notification Of Change Of Address, Business Ownership, Or Discontinuance Of Business Form - California Employment Development Department
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1NOTIFICATION OF CHANGE OF ADDRESS, BUSINESS OWNERSHIP, OR
DISCONTINUANCE OF BUSINESS
Mail to: Employment Development Department
Status Unit—MIC 28
P.O. Box 826880
YOUR ACCOUNT NUMBER
Sacramento, CA 94280-0001
PLEASE INDICATE THE CHANGE(S) TO YOUR BUSINESS BELOW:
A.
Address change only (please provide new mailing address/telephone number below).
B.
Business discontinued without successor: ___/___/___ (please provide forwarding address below).
C.
Discontinued paying wages. Last wage payment made on ___/___/___.
D.
Change of business name. New business name: _________________________________________
E.
Change of ownership: Enter exact date ___/___/___ (please provide type of change below).
If A or B checked above:
STREET AND NUMBER
CITY, STATE, AND ZIP CODE
TELEPHONE NUMBER
If E checked above:
Partial sale only, not out-of-business.
Entire business sold (enter successor name and address below).
Corporation formed.
Other (explain):_______________________________________
Corporation dissolved.
OWNER’S NAME(S) FOLLOWING CHANGE
BUSINESS NAME
BUSINESS MAILING ADDRESS
OF OWNERSHIP
NEW Federal Employer Identification Number __________________________________________
Partnership dissolved.
Partner(s) added.
Partner(s) withdrew.
PARTNER(S) ADDED/WITHDRAWN
SOCIAL SECURITY NUMBER
DRIVER’S LICENSE NUMBER
REMINDER: If you have discontinued paying wages or have discontinued your business without a successor,
you have ten (10) days to file your final DE 88 with payment, Quarterly Wage and Withholding
Report (DE 6), and Annual Reconciliation Statement (DE 7).
SIGNATURE
FOR DEPARTMENT USE ONLY
TITLE
(
)
ENTERED BY: ____________ DATE: ___/___/___
PHONE NO.
DE 24 Rev. 1 (5-99) (INTERNET)
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