Eft-102 (N. 3-10) Electronic Filing Or Electronic Payment Waiver Request

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Electronic Filing or Electronic Payment
Waiver Request
Request for E-File Waiver
Request for Electronic Funds Transfer Waiver
Legal Name / Business Name
Wis. Tax Number (WTN)
Mailing Address
Type of Tax / Return
City
State
Zip
1. Describe the undue hardship to e‑filing your return and include a detailed computation of any additional
costs to complying with the e‑filing requirement.
2. Identify the steps you have taken to timely e‑file and why the steps were unsuccessful.
3. Explain the steps you will take to assure future e‑filing.
Under penalties of law, I declare that the information contained in this waiver request is true, correct and complete to
the best of my knowledge.
Signature of taxpayer or officer authorized to sign the return
Date
Allow 60 days from time of filing waiver request for processing of the waiver request.
Place for filing: Wisconsin Department of Revenue
Address:
PO Box 8949
Madison WI 53708‑8949
FAX Number:
(608) 267‑1030
EFT-102 (N. 3-10)
Wisconsin Department of Revenue

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