Form 1120nf - Nebraska Financial Institution Tax Return - 2012 Page 6

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E-Pay (ACH Debit and ACH Credit). Pay the amount due electronically. It's secure, easy, and fast.
Details on EFT payments can be found in the "Make a Payment" section on the Department’s website.
Credit Card. Secure credit card payments can be initiated through Official Payments at
, or via telephone at 800-2PAY-TAX. Eligible credit cards include
American Express, Discover, MasterCard, and VISA. A convenience fee (2.49% of the tax payment,
$1 minimum) will be charged to the card you use. This fee is paid to the credit card vendor, not
the State, and will appear on your credit card statement separately from the tax payment.
Check or Money Order. Make check or money order payable to the Nebraska Department of
Revenue. Checks written to the Department may be presented for payment electronically.
LINE 16
Overpayment. If the amount on line 14 is greater than line 13, enter the difference as an overpayment
on line 16.
LINE 18
Amount to be Refunded. The Department recommends having any refund on line 18 directly
deposited to your bank account. See line 19 instructions below.
LINES 19A-19D
Direct Deposit. To have your refund directly deposited into your checking or savings account,
enter the routing number and account number associated with the account.
u 19a. The routing number is listed first and must be nine digits.
u 19b. Indicate the type of account – checking or savings.
u 19c. The account number is listed to the right of the routing number and can be up to
17 characters.
u 19d. Box 19d is used to comply with new banking rules regarding International ACH
Transactions (IATs). These refunds cannot be processed as direct deposits and instead, will
be mailed.
Sign and Date the Tax Return. This return must be signed by an officer of the financial institution.
If another person is authorized to sign this return, there must be a
power of attorney
on file with
the Department or attached to the return.
Paid Preparer’s Use Only. Any person who is paid for preparing a financial institution’s return
must also sign the return as a preparer. The preparer must enter his or her Preparer Tax ID Number
(PTIN), their firm’s name, and Federal Employer ID Number (EIN).
Contact Information. If you need additional assistance, contact:
Nebraska Department of Revenue
PO Box 94818
Lincoln, NE 68509-4818
800-742-7474 (Nebraska and Iowa)
402-471-5729
6

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