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State of CaliforniaDepartment of Health Services×HR IIF Reattachment 3 PAYEE DATA RECORD(Required when receiving payment from the State of California in lieu of IRS W9) STD. 204 (Rev. 62003) 1 INSTRUCTIONS:
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What is State of CaliforniaDepartment of Health ServicesHRIIF RFA Form?

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The California Department of State.
Businesses operating in the state of California.
By following the instructions provided by the California Department of State.
To maintain accurate records of businesses operating in California.
Business information, ownership details, and financial data.
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