Form Eft-1 - Authorization Agreement For Electronic Funds Transfer (Eft) Page 2
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1
2FORM EFT-1
Page 2
(REV. 2014)
PART III
Changing Bank Information for ACH Debit Method
Access Code __ __ __ __ __ __ __ __
Date bank information will be changed:
OLD BANK INFORMATION
Account Name
Account Number
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
(Not to exceed 17 digits)
Bank Name
Transfer/Routing Number
___ ___ ___ ___ ___ ___ ___ ___ ___
(Requires 9 digits)
NEW BANK INFORMATION
Reminder: Please attach voided check.
Account Name
Account Number
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
(Not to exceed 17 digits)
Bank Name
Transfer/Routing Number
___ ___ ___ ___ ___ ___ ___ ___ ___
(Requires 9 digits)
GENERAL INSTRUCTIONS
Method II — ACH Debit (Payment through
Signature
the telephone)
Please make a copy of your application for
Form EFT-1 must be signed by an owner,
your records.
partner or member, fiduciary, or officer.
Check the box for Method II if you wish to pay
by ACH Debit (Payment through the telephone).
For more information, see Tax Information
If you wish to use Method II, Form EFT-1 must be
Release (TIR) No. 95-06, “Questions and Answers
Please provide your complete bank information
signed by an owner, partner or member, fiduciary, or
on Paying Taxes by Electronic Funds Transfer;”
and attach a voided check.
officer who is authorized to sign checks drawn on
TIR No. 99-01, “Filing of Tax Returns Required by
the account identified on the form.
If you will be paying for more than one tax type
Taxpayers Who Pay Taxes by Electronic Funds
using the same bank account and same HTIN,
IMPORTANT INFORMATION
Transfer (EFT);” and TIR No. 2004-01, “Act 113,
only one Form EFT-1 should be completed. You
Session Laws of Hawaii 2004, Relating to Income
may pay for any of the taxes listed on the form by
If you checked Method II or Method III,
Tax Withholding.”
EFT even if you do not exceed $100,000 for that
you will receive a confirmation letter in the mail
particular tax type ($40,000 for withholding taxes).
PENALTIES.
Section
231-9.9,
Hawaii
after you file Form EFT-1. The letter will include
Revised Statutes (HRS), imposes a penalty of
instructions for how to make a payment using
If you will be using more than one bank
2% of the amount of the tax due if those who
your chosen method. No ACH Debit or ACH
account or HTIN, please complete a Form EFT-1
are required to make payments by EFT do not
Credit EFT payments should be attempted before
for each account or HTIN you will be using.
do so on or before the date prescribed without
the confirmation letter is received.
The bank information can be obtained from
reasonable cause. This is in addition to any
Method II applicants will also receive their
your bank or at the bottom of the check from the
other penalties. Also, section 40-35.5, HRS,
access code with the confirmation letter. The
account you wish to be debited.
allows the Department of Taxation (Department)
personal identification number (PIN) will be
Account number should not exceed 17 digits.
to assess a $25 service fee on electronic funds
mailed under separate cover from the data
transfer payments that are dishonored for any
Transfer/Routing Number requires 9 digits.
collection center.
reason. This service fee cannot be waived.
Omit hyphens in your bank numbers.
Method III applicants should be aware that
SPECIFIC INSTRUCTIONS
the Department may withdraw its approval for
Please remember to attach a voided check
use of ACH Credit for failure to conform to the
from the bank account you want debited.
Part I
Taxpayer Information
—
requirements for ACH Credit transactions.
Method III — ACH Credit
Method I applicants will not be sent a
All taxpayer information must be completed
and must match the taxpayer information on file
confirmation letter in the mail. After submitting
Check the box for Method III if you wish to pay
with the Department.
your Form EFT-1 to notify us of your intent
by ACH Credit.
to file and pay using our Electronic Services
Some
financial
institutions
offer
ACH
Part II
Method of EFT Payment
—
website,
you
must
register
for
an
E-File
origination services. Contact your bank to
account at tax.hawaii.gov/eservices/ or the
Check the applicable box to indicate your
determine what ACH origination services it offers
Department’s Internet Bulk Filing website at
method of EFT payment.
and the costs of ACH Credit service. You cannot
dotax.ehawaii.gov/bulktax. Afterwards, you will
use Method III unless your bank can initiate
receive an e-mailed confirmation of your registration.
Method I — Payment through the State of
transactions in the CCD+TXP format.
You must submit a Form EFT-1 if you wish
Hawaii Department of Taxation Electronic
Please remember that if you use Method
to change from one ACH payment method to
III, the Department is not responsible for the
Services Website or Internet Bulk Filing
the other. You must continue making your tax
successful completion of EFT transactions that
payments through EFT using the method in use
Website
are required by law. Furthermore, the Department
until you receive confirmation authorizing the
Check the box for Method I to notify the
will not pay any costs your financial institution
change and the effective date of the change.
Department that you will make your tax payments
may charge you for its services.
If you have any questions, please contact the
through the Department’s Electronic Services
website or Internet Bulk Filing website.
Part III
Changing Bank Information
Department’s Electronic Processing Section at:
—
E-mail: Tax.Efile@hawaii.gov
At the Electronic Services website, you have
for ACH Debit Method
the option of paying by credit card or by electronic
Telephone: 808-587-1740
Provide your complete bank information
check (eCheck). A processing fee applies for all
for your old bank account and your new
Fax: 808-587-1488
payments made through the Electronic Services
bank account. If you are changing your bank
website. Credit card payments are also subject to
Mail the completed Form EFT-1 to:
information and the effective date of change is
a 2.4% service fee on the payment amount. You
noted on Form EFT-1, the change will be done no
are responsible for these fees. All fees are non-
EFT Program
earlier than that date.
waivable. Payments made through the Internet
Hawaii Department of Taxation
Please remember to attach a voided check
Bulk Filing website are ACH Debit transactions.
P.O. Box 259
from the new bank account you want debited.
A processing fee will apply to each transaction
made through the Internet Bulk Filing website.
Honolulu, HI 96809-0259
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