Form Tc-85 - Agreement For Remitting Utah State Tax Payments By Electronic Funds Transfer - Utah State Tax Commission Page 2

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EFT METHOD - TAXPAYER WILL INITIATE TAX PAYMENTS EACH MONTH USING THE EFT
PROCEDURE INDICATED BELOW (check one box only)
TAXPAYER elects to initiate ACH-DEBIT transactions to withdraw funds from TAXPAYER's bank account, identified
previously, pursuant to instructions TAXPAYER gives to the USTC Data Collection Agent each month. A voided
check or deposit slip for this bank account is attached.
The USTC and Data Collection Agent warrants to transfer only those debit transactions and to withdraw only those
funds from TAXPAYER's bank account that TAXPAYER explicitly authorizes.
TAXPAYER BANK INFORMATION (For ACH-DEBIT Option Only)
Taxpayer bank's name
Bank's ABA number (9 digit number)
Bank's address
Taxpayer's bank account number
Bank's City
Bank's State
Bank's ZIP Code
Account type (checking, savings, etc.)
ACH-CREDIT
TAXPAYER will initiate tax payments to the USTC each month through ACH-CREDIT transactions. TAXPAYER
agrees to contact its bank authorizing it to transfer payments through NACHA system's CCD+ application and Tax
Payment Convention (TXP) addendum.
TAXPAYER understands that, in order for its EFT payment to be considered timely made, the payment must be initiated
with the USTC Data Collection Agent or TAXPAYER's bank, as appropriate, prior to 3:00pm Salt Lake City time on the
due date. If the due date falls on a weekend or holiday, the payment must be initiated by 3:00pm Salt Lake City time on
the next business day.
TAXPAYER may at any time and with 10 days written notice to the USTC, change banks or bank accounts, and change
from the ACH-CREDIT to the ACH-DEBIT method of EFT remittance. A change from the ACH-DEBIT to the ACH-CREDIT
method shall be made only with prior written approval of the USTC.
This agreement shall continue in full force and effect until USTC receives written notice of a modification permitted by this
AGREEMENT, or TAXPAYER's termination of an election to remit sales taxes by EFT, or until TAXPAYER no longer meets
the requirements for mandatory EFT remittance of sales taxes.
TAXPAYER CERTIFIES THAT ALL INFORMATION PROVIDED IN THIS AGREEMENT IS TRUE,
COMPLETE, AND CORRECT.
Title
TAXPAYER Authorized Signature
Date
Utah State Tax Commission
210 North 1950 West
Salt Lake City, Utah 84134
Telephone (801) 297-2200
For questions regarding this agreement form, call (801) 297-3817.

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