Form Mf-Eft-1 - Motor Fuel Tax Authorization Agreement For Electronic Funds Transfer
Download a blank fillable Form Mf-Eft-1 - Motor Fuel Tax Authorization Agreement For Electronic Funds Transfer in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Mf-Eft-1 - Motor Fuel Tax Authorization Agreement For Electronic Funds Transfer with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1STATE OF ARKANSAS
STATE OF ARKANSAS
MF-EFT-1
MF-EFT-1
DEPARTMENT OF FINANCE & ADMINISTRATION
DEPARTMENT OF FINANCE & ADMINISTRATION
MOTOR FUEL TAX
MOTOR FUEL TAX
AUTHORIZATION AGREEMENT FOR ELECTRONIC FUNDS TRANSFER
AUTHORIZATION AGREEMENT FOR ELECTRONIC FUNDS TRANSFER
PLEASE ENTER YOUR MOTOR FUEL TAX ACCOUNT NUMBER
GASOLINE IMPORTER #
DIESEL IMPORTER #
GASOLINE 1ST RECEIVER #
DIESEL 1ST RECEIVER #
LP GAS #
PE FEE #
PLEASE PRINT OR TYPE
A
BUSINESS NAME
FEIN
C
PHONE (
)
PRIMARY EFT CONTACT PERSON
O
N
ADDRESS
T
CITY, STATE, ZIP
A
PHONE (
)
SECONDARY EFT CONTACT PERSON
C
ADDRESS
T
(S)
CITY,STATE ,ZIP
SIGNATURE OF OWNER, PARTNER OR OFFICER
DATE
CHOOSE ONLY ONE OF THE TWO PAYMENT OPTIONS BELOW
COMPLETE THIS SECTION ONLY IF YOU CHOOSE THE ACH DEBIT OPTION
B
IF THE ACH DEBIT IS CHOSEN, YOU AUTHORIZE THE DEPARTMENT OF FINANCE & ADMINISTRATION OR ITS AGENT TO PRESENT DEBIT ENTRIES TO YOUR
BANK FOR THE TAX SPECIFIED ABOVE . ONLY YOU CAN INITIATE A DEBIT BY CALLING THE STATE'S SERVICE BUREAU AND INDICATING THE AMOUNT OF
A
TAX TO BE PAID BY EFT.
AN AUTHORIZED REPRESENTATIVE OF YOUR BANK MUST COMPLETE AND SIGN THIS SECTION OF THE FORM.
C
H
BANK NAME
BANK ADDRESS
D
CITY,STATE,ZIP
E
B
ROUTING / TRANSFER #
BANK ACCT.#
I
PRINTED NAME OF BANK REPRESENTATIVE
T
SIGNATURE OF BANK REPRESENTATIVE
DATE
SIGNATURE OF OWNER, PARTNER OR OFFICER
DATE
c
COMPLETE THIS SECTION ONLY IF YOU CHOOSE THE ACH CREDIT OPTION
A
AN AUTHORIZED REPRESENTATIVE OF YOUR BANK MUST SIGN THIS SECTION OF THE FORM
C
CONFIRMING THAT YOU AND YOUR BANK ARE CAPABLE OF INITIATING ACH CREDITS IN
H
THE REQUIRED CCD + TXP FORMAT.
BANK NAME
C
R
BANK ADDRESS
E
CITY, STATE ZIP
D
PRINTED NAME OF BANK REPRESENTATIVE
I
SIGNATURE OF BANK REPRESENTATIVE
DATE
T
SIGNATURE OF OWNER, PARTNER OR OFFICER
DATE
COMPLETE THIS FORM AND RETURN TO :
MOTOR FUEL TAX SECTION, P O BOX 1752, LITTLE ROCK AR 72203-1752
PHONE (501) 682-4800
FAX (501) 682-5599
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form 90-302 - Iowa Motor Fuel Tax Authorization Agreement For Electronic Funds Transfer (eft)
Financial
Form 90-302 - Motor Vehicle Fuel Tax Authorization Agreement For Electronic Funds Transfer (eft)
Financial
Form Eft-1 - Authorization Agreement For Electronic Funds Transfer (eft) - Hawaii Department Of Taxation
Financial
Form Eft-1 - Authorization Agreement For Electronic Funds Transfer For Real Estate And/or Personal Property Taxes
Financial
Form Eft-1 St - Authorization Agreement For Electronic Funds Transfer Of Sales And Use Tax
Financial
Related Categories
Parent category: Financial