Form 78-004 - Efile And Pay Bulk Filer Application - Iowa Department Of Revenue printable pdf download

Iowa Department of Revenue

eFile & Pay Bulk Filer Application

https://tax.iowa.gov

A Bulk Filer (or Service Provider) is a third party who, by agreement, files electronic tax transactions,

either in bulk or single entry online, on behalf of taxpayer clients.

Legal Name __________________________________________________________________

Mailing Address ______________________________________________________________

City _________________________ State _______ ZIP ___________________

Federal Employer Identification Number (FEIN) ________________________________________________

Social Security Number, if sole proprietor ____________________________________________________

Contact Name ________________________________________________________________

Contact Phone ______________________ Contact Fax _____________________

Contact Email ___________________________________

Upon receipt of this application, the department will send a letter to you specifically for bulk filers. A Business

eFile Number (BEN) will also be provided by mail, unless you already have one. If you already have a BEN, a

new number will not be issued. Additional information for bulk filers may be found on our website.

As a third party bulk filer, you have the option to file a client’s transaction information individually online through

eFile & Pay or submit a file containing transactions for multiple clients.

NOTE: One electronic payment cannot cover multiple transactions.

All of your clients must be properly registered with the Iowa Department of Revenue.

Any transactions filed for unregistered clients will be rejected.

Name of Owner, Officer, Partner or Responsible Party ________________________________

Signature of Owner, Officer, Partner or Responsible Party _____________________________

Date ___________________

By submitting this application, the above party agrees to abide by the statutes and regulations of the State of

Iowa in the filing of returns on behalf of taxpayers. This application does not grant power of attorney to the

above party to act on behalf of the taxpayer regarding tax matters with the Iowa Department of Revenue or

allow the above party to act as an agent of the department.

Bulk filers may wish to have an Iowa Power of Attorney form on file with the department for their clients. A

Power of Attorney form is available at the department’s website.

Questions? Contact Taxpayer Services at 515.281.3114

Fax completed application to: Registration Services at 515.281.3906

Or mail to:

Registration Services

Iowa Department of Revenue

PO Box 10470

Des Moines, IA 50306-0470

78-004 (07/29/15)

Form 78-004 - Efile And Pay Bulk Filer Application - Iowa Department Of Revenue