New York State Taxpayer Authorization

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Department of Taxation and Finance
New York State Taxpayer Authorization for
Electronic Funds Withdrawal for Tax Year 2016
Form IT-370 and Tax Year 2017 Form IT-2105
Electronic return originator (ERO): Do not mail this form to the Tax Department. Keep it for your records.
Taxpayer’s name:
Spouse’s name:
( jointly filed IT-370 only)
Purpose
This form is for use by EROs only. An ERO must complete this form when:
• The ERO is e-filing 2016 Form IT-370, Application for Automatic Six-Month Extension of Time to File for Individuals, and
• the payment of the balance due on the e-filed IT-370 is being made by electronic funds withdrawal through an approved e-file
software package.
OR
• The ERO is e-filing 2017 Form IT-2105, Estimated Tax Payment Voucher, and
• the payment on the e-filed Form IT-2105 is made by electronic funds withdrawal through an approved e-file software package.
Do not use this form to authorize payment on Form IT-370 or Form IT-2105 if an electronic funds withdrawal is not used or if
you are filing Form IT-370 or Form IT-2105 on the Tax Department’s website.
Instructions
Complete this form only when you transmit an electronically filed Form IT-370 or IT-2105 and payment is being made by
electronic funds withdrawal.
Important: You do not need to complete Form TR-579.1-IT for Form IT-370 extension requests if no payment is required, a
paper check is used for the payment, or you are using the Tax Department’s Internet extension application.
Do not mail Form TR-579.1-IT to the Tax Department. The ERO must keep this form for three years and present it to the Tax
Department upon request.
Taxpayer authorization for electronic funds withdrawal for Form IT-370 and Form IT-2105
I authorize my ERO to transmit the information necessary for the New York State Tax Department to initiate an electronic
funds withdrawal for the amount specified on this form from the financial institution account indicated below. I certify that the
account holder has authorized the New York State Tax Department and its designated financial agents to initiate an electronic
funds withdrawal from the financial institution account indicated on my 2016 electronic extension request, or 2017 estimated
tax payment voucher, and authorized the financial institution to withdraw the amount from that account. As New York does not
support International ACH Transactions (IAT), I attest the source for these funds is within the United States. I understand and
agree that I may revoke this authorization for payment only by contacting the Tax Department no later than five (5) business
days prior to the payment date.
Financial institution information
1 Amount due with extension or estimated tax payments
1.
.............................................................
2 Financial institution routing number
2.
.............................................................................................
3 Financial institution account number
3.
...........................................................................................
4 Account type:
Personal checking
Personal savings
Business checking
Business savings
Taxpayer’s signature:
Date:
(Only one account holder signature is necessary for jointly filed returns.)
Print name:
TR-579.1-IT (1/17)

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