Direct Payment Ach Credit Authorization Fo Page 6

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State of Idaho
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ACH Credit Authorization
Taxpayer name
Taxpayer identification number
Contact person
Telephone number
Address
Taxes to be paid using ACH Credit
Idaho ID number
Contact name, address and phone
Tax Type code
IDAHO STATE TAX COMMISSION
Attention: Accounting
P O Box 36
Boise, Idaho 83722-0120
FAX number: (208) 334-7625
SS00501
4
8-09-00

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