Annual Income Report For Disability Insurance Elective Coverage {DE 945}

DE 945, ANNUAL INCOME REPORT FOR DISABILITY INSURANCE ELECTIVE COVERAGE, The net profit or loss reported for the calendar year listed above determines your quarterly premiums and benefits for future years. Sections 708 and 708.5 of the California Unemployment Insurance Code require participants to provide a copy of their annual income statement of net profit or loss as reported to the IRS for the prior tax year to the Employment Development Department (EDD). If your tax filing period with the IRS is not based on a calendar year (January 1 to December 31), please provide your tax period ending date and the due date reported with the IRS for filing your taxes. This information will assist the EDD in posting your annual income to the correct period for premium and benefit determination purposes. Failure to timely submit this signed form with the requested information without good cause may result in receiving delinquency notices and potentially impact your future Disability Insurance benefits. www.FormsWorkflow.com