State of California
Earned Income Tax Credit Notice
California employers are required to notify all employees that they may be eligible for the federal Earned Income Tax Credit (EITC) by giving them a separate notice. This notice must be given one week before, after, or at the same time that the employer provides an annual wage summary.
Employers can provide notification by handing directly to the employee or mailing to the employee’s last known address.
Please feel free to duplicate this form and distribute as appropriate.
To California Employee:
“Based on your annual earnings, you may be eligible to receive the earned income tax credit from the federal government. The earned income tax credit is a refundable federal income tax credit for low-income working individuals and families.
The earned income tax credit has no effect on certain welfare benefits. In most cases, earned income tax credit payments will not be used to determine eligibility for Medicaid, Supplemental Security Income, food stamps, low-income housing or most temporary assistance for needy families’ payments.
Even if you do not owe federal taxes, you must file a tax return to receive the earned income tax credit. Be sure to fill out the earned income credit form in the federal income tax return booklet.
For information regarding your eligibility to receive the earned income tax credit, contact the Internal Revenue Service by calling 1-800-829-3676 or through its web site at www.irs.gov.”
The Deka Business Solutions teams