Tax Processing Sales Tax E-Filing Agreement For File Transmissions Form

Tax Processing Sales Tax E-Filing Agreement For File Transmissions Form - State Of Wisconsin Page 6

EXHIBIT A

COMPANY & PRODUCT INFORMATION

1. Company name: __________________________________________________________

Address:

__________________________________________________________

Federal Employer Identification Number (FEIN): _________________________________

2. Name of e-file product(s): ___________________________________________________

________________________________________________________________________

3. Home Page URL to which the DOR may link.

________________________________________________________________________

4. Company contact regarding this program is:

Name: __________________________________________________

E-mail address: ___________________________________________

Phone number: ___________________________________________

Postal Address: ___________________________________________

5. Company contact with authority to receive all written notices required by this Agreement is:

Name: __________________________________________________

E-mail address: ___________________________________________

Phone number: ___________________________________________

Postal Address: ___________________________________________

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Tax Processing Sales Tax E-Filing Agreement For File Transmissions Form - State Of Wisconsin Page 6