Edd Form De 9406 PDF Details

Navigating the complexities of financial accountability and legal obligations, especially for taxpayers, can be a daunting task. The Edd De 9406 form, a document designed for the detailed delineation of an individual's financial condition alongside their income and expense declaration, serves as a cornerstone for these responsibilities. Aimed primarily at taxpayers, this form requires thorough disclosure of personal information, including name, date of birth, social security number, and detailed contact information, extending to include the same for a spouse or registered domestic partner if applicable. The document further delves into the realm of financial intricacies by asking for an extensive breakdown of income sources, dependencies, liabilities, and assets, effectively painting a comprehensive picture of one's economic stature. Significant too is the inclusion of information pertaining to legal representatives, creating a bridge for communication between the taxpayer and legal entities or the Employment Development Department (EDD). With sections dedicated to asset declaration—from real estate and motor vehicles to securities and life insurance policies—the form also ventures into liabilities, ensuring all outstanding debts and monthly expenses are meticulously accounted for. This form not only facilitates a better understanding of an individual's financial health but also aids in the equitable assessment and processing of any financial responsibilities or entitlements, making it a pivotal document for both the taxpayer and the governing bodies.

QuestionAnswer
Form NameEdd Form De 9406
Form Length5 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 15 sec
Other namesedd form de 2525xfa, expense, and, grantor

Form Preview Example

COMBINED STATEMENT OF FINANCIAL CONDITION And

INCOME AND EXPENSE DECLARATION

I. TAXPAYER

Name (first)

(middle)

 

(last)

Date of Birth (mo., day, year)

Social Security Number

 

 

 

 

 

 

Address (number and street)

 

 

 

Driver’s License Number

Telephone Number (home)

 

 

 

 

 

 

(City, Town or Post Office)

(County)

 

(State)

(ZIP Code)

Telephone Number (work)

 

 

 

 

 

Spouse/Registered Domestic Partner’s Name (first)

(middle)

(last)

Date of Birth (mo., day, year)

Social Security Number

 

 

 

 

Spouse/Registered Domestic Partner’s Employer (If self-employed, list here)

 

 

Spouse/Registered Domestic

 

 

 

 

 

Partner’s Driver’s License Number

 

 

 

 

 

 

Address (Number and Street)

(City, Town, or Post Office)

(County)

(State)

(ZIP Code)

Telephone Number

 

 

 

 

 

Nearest Living Relative Not Residing in Household

 

 

 

Relationship

 

 

 

 

 

 

Address (Number and Street)

(City, Town, or Post Office)

(County)

(State)

(ZIP Code)

Telephone Number

 

 

 

 

 

 

II. REPRESENTATIVE OF TAXPAYER (Complete this section if Taxpayer’s representative appears).

Name (If represented by a legal counsel give name of firm and individual.)

Address (Number and Street)

(City, Town, or Post Office)

(County)

(State)

(ZIP Code)

Telephone Number

III.TAXPAYER INCOME AND EXPENSE DECLARATION

A.An order assigning salary and wages for support is now in effect as to my earnings. The amount payable under that order is: $________________ (A copy of that order is attached.)

B.I need the following earnings to support myself and my family:

All earnings

$

 

each pay period.

C.I am willing for the following amount to be withheld from my earnings during the withholding period. I understand that the Employment Development Department can accept this offer which will result in the following sum being withheld each pay period.

None

Withhold $

 

each pay period.

I am paid:

Daily

Weekly

Twice a month

Every two weeks

Monthly

My Gross Pay is:

$ ___________________

My Net Pay is:

$ ___________________

D.The following persons depend, in whole or in part, on me for support:

NAME

AGE

RELATIONSHIP TO ME

MONTHLY INCOME

SOURCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DE 9406 Rev. 3 (2-11) (INTERNET)

Page 1 of 1

CU

E. The earnings of persons listed in Item III.D. are now subject to wage assignments and earnings withholding orders as follows (specify):

 

 

 

GROSS MONTHLY INCOME

 

 

 

DEDUCTIONS FROM GROSS MONTHLY INCOME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Earnings (Include commissions, bonuses,

 

 

 

 

 

 

 

and overtime.) --------------------------------------------

 

$

 

 

State Income Taxes ----------------------------------

$

 

Pensions and Retirement -----------------------------

 

 

 

 

Federal Income Taxes -------------------------------

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Property Taxes (Not included in house

 

 

Social Security -------------------------------------------

 

 

 

 

Payment.) ------------------------------------------------

 

 

Disability and/or Unemployment Insurance ------

 

 

 

 

Social Security (OASDI) -----------------------------

 

 

Public Assistance (Welfare, AFDC

 

 

 

 

 

 

 

Payments, etc.) -------------------------------------------

 

 

 

 

State Disability Insurance ---------------------------

 

 

Child and/or Support Orders

 

 

 

 

 

 

 

(Attach any support orders.) --------------------------

 

 

 

 

Medical and Other Insurance ----------------------

 

 

Dividends and Interest ---------------------------------

 

 

 

 

Union and Other Dues --------------------------------

 

 

Rents (Gross receipts, less cash expenditures –

 

 

 

 

 

 

 

attach statement.) ---------------------------------------

 

 

 

 

Retirement and Pension Fund ---------------------

 

 

Contributions to Household Expenses From

 

 

 

 

 

 

 

Other Sources --------------------------------------------

 

 

 

 

TOTAL REQUIRED DEDUCTIONS --------------

$

 

Income From Business or Profession

 

 

 

 

OTHER DEDUCTIONS FROM INCOME

 

 

 

 

 

 

 

Income From Partnership ------------------------------

 

 

 

 

Savings Plan -------------------------------------------

 

 

Income From Annuity ---------------------------

 

 

 

 

Other (Itemize) -----------------------------------------

 

 

Income From Estate or Trust -------------------------

 

 

 

 

 

 

 

Other Income (Itemize) --------------------------------

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GROSS MONTHLY INCOME ----------------------

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LESS DEDUCTIONS FROM INCOME ----------

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NET PERSONAL INCOME -------------------------

$

 

 

 

 

 

 

 

 

 

 

 

 

 

LESS MONTHLY EXPENSES (Page 3) --------

 

 

TOTAL EARNINGS

 

$

 

 

NET DISPOSABLE INCOME ----------------------

$

 

 

 

 

 

 

F. Withholding Information – Taxpayer

 

 

 

 

 

 

Self

 

 

 

 

 

 

 

Spouse/Registered

 

 

 

 

 

 

Domestic Partner

 

 

 

 

 

 

 

Filing Status (shown

 

 

 

 

 

 

on Income Tax Return)

 

 

 

 

 

 

 

No. of Dependents

 

 

 

 

 

 

 

 

No. of Exemptions You Claim

 

 

 

 

 

 

 

 

DE 9406 Rev. 3 (2-11) (INTERNET)

 

 

Page 2 of 5

 

 

IV. STATEMENT OF FINANCIAL CONDITION

A.

ASSETS

 

 

LIABILITIES

 

 

 

 

 

 

 

 

 

 

 

Cash ---------------------------------------------------------

$

 

Rent ----------------------------------------------------------

$

 

 

Real Estate ------------------------------------------------

 

 

Food ----------------------------------------------------------

 

 

 

Furniture and Fixtures ---------------------------------

 

 

Clothing ------------------------------------------------------

 

 

 

Machinery and Equipment ----------------------------

 

 

Utilities -------------------------------------------------------

 

 

 

Motor Vehicles, Airplanes, or

 

 

 

 

 

 

 

Boats -------------------------------------------------------

 

 

Auto Payments ---------------------------------------------

 

 

 

Securities, Bonds or Savings Bonds ---------------

 

 

Auto Expenses (Gas, oil, insurance, etc.)-----------

 

 

 

 

 

 

 

Installment Payments (Itemize on

 

 

 

Cash Surrender Value of Life Insurance ----------

 

 

separate sheet, if necessary.) -------------------------

 

 

 

Accounts Receivable and/or

 

 

 

Child and/or Support Orders

 

 

 

Notes Receivable ---------------------------------------

 

 

(Attach any support orders.) ---------------------------

 

 

 

Merchandise Inventory --------------------------------

 

 

Life Insurance Premiums -------------------------------

 

 

 

Other Assets (Itemize) ----------------------------------

 

 

Medical Expenses ----------------------------------------

 

 

 

 

 

 

 

Miscellaneous (Child care, laundry,

 

 

 

(Attach additional pages as needed.)

 

 

school, etc.) ------------------------------------------------

 

 

 

TOTAL ASSETS ----------------------------------------

$

 

TOTAL LIABILITIES -------------------------------------

 

 

 

B. I have accounts in the following bank(s), credit union(s), or financial institution(s)

Name of Bank, Credit Union, or Financial Institution

Account Number

Address

C. I rent a safety deposit box.

No Yes

Box is rented in My name

Another name

Name of Boxholder

Name of Bank

Address of Bank

D. Description of Real Estate (e.g., house and lot, Sacramento County):

Fair Market Value

$

Balance Due

$

TOTAL REAL ESTATE VALUE -------------------------------------------------------------------------------------------------

$

$

E. I have filed a Declaration of Homestead for Real Property.

No

Yes

 

 

 

DE 9406 Rev. 3 (2-11) (INTERNET)

Page 3 of 5

F. Description of Motor Vehicles, Airplanes, or Boats (Include License, Vessel, or Tail Nmber.)

Fair Market Value

$

Balance Due

$

TOTAL VALUE ------------------------------------------------------------------------------------------------------------------------

$

$

G. Securities, Stocks, Bonds, and Savings Bonds

 

 

 

Number of Units

Fair Market Value

Balance Due

$

$

Name of Stockbroker

Address

H. Description of Furniture and Fixtures, Machinery and Equipment

 

 

 

 

 

Fair Market Value

Balance Due

 

 

 

 

 

 

 

 

 

 

 

Furniture (Household) -----------------------------------------------------------------------------------------------------------

 

 

 

 

 

 

$

 

$

 

Furniture /Fixtures (Business) -------------------------------------------------------------------------------------------------

 

 

 

 

 

 

 

 

 

 

Machinery ---------------------------------------------------------------------------------------------------------------------------

 

 

 

 

 

 

 

 

 

 

Equipment (Other than motor vehicles) -------------------------------------------------------------------------------------

 

 

 

 

 

 

 

 

 

 

Miscellaneous----------------------------------------------------------------------------------------------------------------------

 

 

 

 

 

 

 

 

 

 

TOTAL VALUE -------------------------------------------------------------------------------------------------------------------

 

 

 

 

 

 

$

 

$

 

I. Life Insurance Policies Now in Effect

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Right to Change

Name of Company

Policy Number

 

Policy Amount

Cash Surrender Value

 

Balance Due on Loan

Beneficiary (Y or N)

 

 

 

$

$

 

 

$

 

 

 

 

 

 

$

$

 

 

$

 

 

 

 

 

 

$

$

 

 

$

 

 

 

 

 

 

$

$

 

 

$

 

 

 

J. Accounts or Notes Receivable (Furnish a copy of the instrument creating the Accounts or Notes Receivable.)

 

 

 

 

Name

 

Address

Phone Number

Fair Market Value

Balance Due

$

$

$

$

$

$

$

$

$

$

DE 9406 Rev. 3 (2-11) (INTERNET)

Page 4 of 5

K. Other Assets

If you have any Life Interest or Remainder Interest, either vested or contingent, in any trust or estate, or are a beneficiary of any trust, complete the following information, and furnish a copy of the instrument creating the trust or estate.

Name of Trust or Estate

Present Value of Trust

$

$

$

Value of Your Interest

$

$

$

Annual Income

$

$

$

If you are the grantor or donor for any trust, or the trustee or fiduciary for any trust, complete the following information, and furnish a copy of the instrument creating the trust.

Name of Corpus or Trust

Value

$

$

$

If you have any other assets, or interests in assets, actual or contingent, other than those listed herein, describe fully:

If any foreclosure proceedings are pending at present on any real estate which you own or in which you have an interest, enter description and location of such real estate.

Was the State of California named as a party to the court filings?

No

Yes If yes, please furnish a copy of the court filings.

DECLARATION

I declare, under penalty of perjury, that the foregoing instruments are true and complete to the best of my knowledge and belief.

Signed on

 

at

 

 

California.

 

(Date)

 

(City)

(County)

 

 

 

 

 

 

 

 

 

(Signature)

DE 9406 Rev. 3 (2-11) (INTERNET)

Page 5 of 5

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Be mindful when filling in this pdf. Make sure each blank is filled in properly.

1. Start completing your section with a selection of essential fields. Note all the required information and be sure not a single thing neglected!

Completing segment 1 in California

2. Once the last segment is finished, you're ready add the required specifics in A copy of that order is attached, All earnings, each pay period, I am willing for the following, None, Withhold, each pay period, I am paid, Weekly, Twice a month, Daily, Every two weeks, Monthly, My Gross Pay is, and My Net Pay is in order to proceed further.

Part # 2 of submitting California

3. The third step is usually hassle-free - fill in all the form fields in State Income Taxes, Federal Income Taxes, Property Taxes Not included in, Social Security OASDI, State Disability Insurance, Medical and Other Insurance, Union and Other Dues, Retirement and Pension Fund, TOTAL REQUIRED DEDUCTIONS, OTHER DEDUCTIONS FROM INCOME, Savings Plan, Total Earnings Include commissions, Pensions and Retirement, Social Security, and Disability andor Unemployment to conclude this part.

California completion process explained (portion 3)

4. The next section will require your involvement in the following parts: Other Itemize, GROSS MONTHLY INCOME, LESS DEDUCTIONS FROM INCOME, NET PERSONAL INCOME, LESS MONTHLY EXPENSES Page, NET DISPOSABLE INCOME, Income From Annuity, Income From Estate or Trust, Other Income Itemize, TOTAL EARNINGS F Withholding, Self SpouseRegistered Domestic, Filing Status shown, and on Income Tax Return No of. Just remember to provide all needed info to move onward.

Part number 4 of submitting California

It is easy to make a mistake when completing the NET DISPOSABLE INCOME, hence make sure you go through it again prior to deciding to send it in.

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The best ways to fill in California step 5

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