CACFP Address Changes

Private and/or Non-Profit Agencies

An agency's authorized representative must contact the Internal Revenue Service (IRS) by calling 877-829-5500 or visit the IRS web page and complete the Change of Address or Responsible Party – Business IRS Form 8822b. After the program operator has submitted the IRS Form 8822b to the IRS, the IRS will send the program operator a revised IRS Determination Letter once the change in legal payment address information has been updated with the IRS.

Note: The California Department of Social Services (CDSS) Child and Adult Care Food Program (CACFP) will not accept the completed IRS Form 8822b as proof of program operator payment address change with the IRS. The program operator must submit to their assigned Program Specialist the revised IRS Determination Letter with the updated program operator payment address listed on the letter.

The Private and/or Non-Profit program operator must submit to their assigned Program Specialist the following to process a payment address change:

• The program operator's updated IRS Determination Letter (with the new payment address listed on the letter)


• The Payee Data Record Form STD 204


• The Payee Data Record Supplement Form STD 205 (if applicable)


• Letter of Explanation on the program operator’s official business letterhead (if possible) explaining the change of payment address. This letter of explanation must include the previous payment address, as well as the reason as to why the previous payment address has been updated to the new payment address. If the program operator does not have an official business letterhead, the program operator must provide this information in an email to their assigned CDSS CACFP Specialist.

Public Agencies

An authorized program operator representative must submit to their assigned Program Specialist the following:

• The public agency’s IRS Form W-9 (with the new payment address updated with the IRS)


• Proof that the public agency has updated the California School Directory with the new payment address for the school/agency.


• A Letter of Explanation on the public agency’s official business letterhead explaining the change of payment address. This letter of explanation must include the previous payment address, as well as the reason as to why the previous payment address has been updated to the new payment address

Note: The CDSS CACFP may require further documentation as requested by the State of California’s Financial Information System (Fi$Cal) department.

Completing the Payee Data Record Form STD 204:

The Payee Data Record, STD. 204, must be completed by all program operators. The purpose of the STD. 204 is to obtain payee information for income tax reporting and to ensure tax compliance with federal and state law. The STD. 204 is required for any entity or individual entering into a transaction that may lead to a payment from the state. Therefore, a completed and signed Form STD 204 with handwritten or electronic signature must be on file with the state before payments can be disbursed.

Section 1

If the program operator does NOT have a Doing Business As (DBA) for their business, complete Line 1 using the Agency Name. Do not enter a personal name. Leave line 2 blank. If the agency has a DBA, enter the DBA on line 2.

Section 2

Enter the Entity Type.

Section 3

Enter either the Social Security Number (Taxpayer Identification Number) or the Federal Employer Identification Number associated with the business.

Section 4

The program operator must indicate whether they are a California Resident OR California Nonresident.

Section 5

The program operator’s Authorized Payee Representative must submit this form with a conventional signature or a certified electronic signature and email this document to their assigned Program Specialist. The form must also have all fields (Sections 1 through 5) completed. The form must be dated with the current date of submission to the assigned Program Specialist.

Completing the Payee Data Record Supplement Form STD 205:

The Payee Data Record Supplement Form, STD 205 is used when a program operator would like to request that their payment address be different from the legal payment address with the IRS (a supplemental address). This affects the program operator’s tax filing address for their business with the IRS. If a Payee Data Record Supplement Form, STD 205, is submitted, the name and signature of the program operator’s Authorized Payee Representative, Title, E-mail Address, Signature, Date, and Telephone must be the same as the Payee Data Record Form, STD 204.

To have the supplemental address processed through the State of California’s Fi$Cal department and the California State Controller’s Office, any Private Non-Profit or Public Agency must submit to their assigned Program Specialist all of the above listed documents, as well as the Payee Data Record Supplement Form, STD 205, with a different address listed than what is listed on the W-9; IRS Determination Letter; and/or the Payee Data Record Form, STD 204.

All legal addresses listed on the W-9/IRS Letter of Determination must match the address on the Payee Data Record Form, STD 204. Use the Payee Data Record Supplement Form, STD 205, for a supplemental address. If a Payee Data Record Supplement Form, STD 205, is submitted, include a Letter of Explanation explaining the difference in addresses.

The Payee Data Record Supplement Form, STD 205’s Section 1, Lines 1 and 2 must match exactly with the submitted W-9/IRS Letter of Determination and the Payee Data Record Form, STD 204.

Once the documentation is complete, including any required supplemental documentation, the documents must then be submitted to the agency’s assigned Program Specialist. The documentation will then be forwarded to the State of California’s Fi$Cal department and the California State Controller’s Office.

Questions: A list of Program Specialists that can assist is found on the CACFP Contact List.

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