Fillable Printable De 1245W
Fillable Printable De 1245W
De 1245W
DE 1245W Rev. 1 (1-17) (INTERNET) Page 1 of 1 CU
E-FILE AND E-PAY MANDATE WAIVER REQUEST
PURPOSE: This form is used to request an exemption from the e-file and e-pay mandate which
requires employers to file their employment tax returns, wage reports, and payroll tax deposits
electronically.
An approved waiver will be valid for one year beginning with the quarter of the request date. Upon the
expiration of the approval period, an employer must start to electronically file and pay, or submit a new
waiver request to avoid a non-compliance penalty. For additional information or questions regarding the
e-file and e-pay mandate, please visit our website at www.edd.ca.gov/EfileMandate or contact the
Taxpayer Assistance Center at 888-745-3886.
This waiver request can be faxed to 916-255-1181 or mailed to:
Employment Development Department
Document and Information Management Center
PO Box 989779
West Sacramento, CA 95798-9779
Important: This form may not be processed if any information is missing.
A. EMPLOYER
INFORMATION
(Complete all items
in this section.)
Employer Payroll Tax Account Number
– –
Business Name
Legal Name
B. REASON
(Select the reason
for filing this e-file
and e-pay mandate
waiver request.)
Lack of automation.
Severe economic hardship.
Current federal exemption from filing electronically.
Other good cause. Please explain below.
Note: Sections 1088(h)(3) and 1110(g)(3) of the California Unemployment
Insurance Code defines waiver criteria.
C. DECLARATION
I certify under penalty of perjury that the above information is true, correct,
and complete. I further certify that I have the authority to sign on behalf of the
above business.
Signature
Date
/ /
Print Name
Title
Phone Number
( ) –
