DE 4 Form

If you want California state income taxes deducted from your paychecks, you have the option to submit a DE 4 Form.

 Mail the completed DE 4 Form to:

 Attn: IHSS Accounting Unit                                                                  

P.O. Box 22006                                                

Santa Ana, CA 92702-2006

 Your DE 4 Form will be REJECTED if you do not fill out the employer information towards the middle, which will result in a DE 4 Form processing delay.

  •  Your IHSS Recipient is your employer.
  • The California Employer Payroll Tax Account Number is your IHSS Recipient’s case number 
DE 4