Form Tr-698 - Promptax-Petroleum Business Tax Change Of Enrollment Information - Nys Tax De Page 3
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4TR-698 (3/06) Page 3 of 4
Change of payment option selection
V.
Complete this section only if the taxpayer wishes to change its payment option.
The taxpayer selects the ACH Debit payment option. Section VI, ACH Debit Authorization, must also be completed.
The taxpayer selects the ACH Credit payment option.
The taxpayer selects the Fedwire payment option.
The taxpayer selects the Certified Check payment option.
ACH Debit Authorization
VI.
Complete this section only if the taxpayer is changing its payment option to ACH Debit from any other payment option or if
the routing transit number and/or account number to be debited has changed.
I, the undersigned, hereby authorize the New York State Department of Taxation and Finance to debit the bank account
indicated below for the purpose of collecting New York State Petroleum Business Tax. Amounts debited shall correspond
to information supplied by the taxpayer in its electronic filing for the applicable period.
If the taxpayer changes its bank and/or the bank account to be debited, I will update the taxpayer’s enrollment information
with the new routing transit number and/or bank account number. Failure to timely notify the Department of a change in
account information may result in an assessment of penalty and interest.
The Tax Department considers the taxpayer bank account information on the ACH Debit Authorization confidential and will
use it only for purposes of tax administration.
You may access the PrompTax Web site at to confirm the effective date and amount of the tax
payment made by the debit transaction.
Enter the taxpayer’s bank account information below. All fields are required.
Routing Transit Number:
Bank Account Number:
Bank Account Category:
Business
Consumer
Bank Account Type:
Checking
Savings
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