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Established in 1914 by the state legislature, State Fund is California's most reliable provider of workers' compensation insurance and a vital asset to California businesses. State Fund supports California's entrepreneurial spirit and plays a stabilizing role in the economy by providing fairly priced workers' compensation insurance, helping California employers keep their workplaces safe, and restoring injured workers.

Single Remittance Address Policy

Beginning August 2011, State Fund will send payments to only one remittance address per Tax Identification Number (TIN).

What this means:

If your company bills State Fund from multiple billing addresses, including through third-party billers, State Fund will send payments to only the tax-reporting address on your IRS Form W-9 (or State Fund’s equivalent SCIF Form 5159) rather than sending payments to multiple addresses. If you wish to use a remittance address separate from your tax-reporting address, you must specify that address on SCIF Form 5159.

Address preference:

Different from Tax-Reporting Address

If you prefer a remittance address different from your tax-reporting address, please fill out completely a SCIF Form 5159 “Request For Taxpayer Identification Number and Certification” to specify the remittance address that State Fund will use for your company.

Download a blank SCIF Form 5159 here.

A blank IRS Form W-9 is available here.


  • If your tax-reporting address is outside of California, a PO box or shows ‘in care of’ (c/o) you must provide a SCIF Form 590 (equivalent to CA Form 590) in addition to a Form 5159 or IRS Form W-9 in order to prevent unnecessary California State Non-resident Withholding.

Download a blank SCIF Form 590 here.

Return the completed and signed form(s) via e-mail to or via fax to 707-454-0880.  (The e-mail address and fax number are for tax forms only, not bills.) Please allow 6 to 8 weeks for processing.

Same as Tax-Reporting Address

If you agree to have your tax-reporting address as your remittance address, you do not have to do anything. (However, you may fill out and submit the form(s) if you want to update your tax information in our records.)

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