Form De 2251a - Affidavit Of Mailing Page 2
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2Instructions for Completing Affidavit of Mailing (DE 2251A)
NOTICE: This form will not be processed unless it is accurately completed according to the following instructions:
• Enter the eight-digit EDD account number and the business name as registered with the EDD.
• Enter the person’s name who will sign the affidavit and who actually deposited the envelope in the
United States mail.
• Enter the date the envelope was originally deposited in the United States mail.
• Check the appropriate box(es) and enter the period covered by the document mailed.
• Enter the check number or warrant number (not federal reserve or bank number), date, and amount.
• Enter the exact location of United States mailbox or United States post office branch where the envelope
was deposited.
• Enter the city, state, and date the affidavit was signed.
• The signature and title of the person signing under penalty of perjury, address of the business, and phone
number, including area code, of the business.
Please mail this form to the address shown on the correspondence which accompanied this form or to
P.O. Box 826805, Sacramento, CA 94205-0001.
DE 2251A Rev. 22 (2-13) (INTERNET)
Page 2 of 2
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