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Form Eft-100s - Electronic Funds Transfer Authorization Agreement For Streamlined Sales Tax Page 2

Page 2

EFT-100S

Electronic Funds Transfer Authorization Agreement

Web

11-06

Instructions

Taxpayer Information

Name and Address

Enter the business name and address of the taxpayer.

Name and Address of Contact Person

This is the individual the Department will contact should there be any question about an EFT tax payment and to whom all

correspondence about the EFT Program will be directed. You must attach a copy of the power of attorney if this person

is not employed by the taxpayer but is authorized to execute and file tax returns on behalf of the taxpayer.

Federal Employer ID Number/SSN number

If the business is a corporation, provide the Federal Employer ID Number. If the business is a sole proprietorship, provide

the owner’s Social Security Number.

Voluntary Participant

As a voluntary participant, you must participate in the Program for a minimum of twelve months. Upon completion of

the twelve month period, you may withdraw from the Program provided you have notified the Department in writing at

least 45 days prior to the first non-EFT payment.

Change of Information/Bank Change

If any information has changed since previously registering, such as the banking information or contact person, please

complete a new authorization agreement with the updated information. Indicate the date the changes should take effect.

Normally, bank changes require 2-3 days to be processed before a payment can be made.

Streamlined Sales Account ID

Taxpayers remitting Streamlined Sales and Use Tax will enter the Streamlined Sales Account ID after the 2 pre-filled

zeros. A Streamlined Sales Account ID will begin with the letter S.

Tax Type

Fill in the circle for the appropriate tax type. If required or requesting to remit electronically for more than one tax type,

you must complete a separate Electronic Funds Transfer Authorization Agreement for each tax type.

General Instructions

Part 1. ACH Credit

To make payments by ACH Credit, first contact your financial institution to confirm they offer ACH Credit origination

services. After registering with the Department for the ACH Credit method, an Information Booklet with detailed

instructions regarding formatting specifications will be sent.

Part 2. Authorized Signature

The Authorization Agreement must be signed by an individual authorized to act on behalf of the taxpayer. Generally, this

is the person with the authority to sign a tax return. ACH Credit filers must complete this certification.

Form Eft-100s - Electronic Funds Transfer Authorization Agreement For Streamlined Sales Tax Page 2