Form 150-206-029 - Ach Debit Authorization Agreement And Application For Combined Payroll Tax And Assessment Page 3
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8Your request for a waiver must be in writing and
change. During this time you will need to make any
received by the department at least 30 days prior
payroll tax payments with a check and OTC coupon.
to your next payment due date. Please write “EFT
What do I do if some or all of my business infor-
Waiver” at the top of your request and include the
mation changes? You must notify the department by
reasons for your request. Send your waiver request
completing a new Authorization Agreement and Ap-
to: EFT Coordinator, Oregon Department of Rev-
plication. A new authorization agreement must be
enue, PO Box 14725, Salem OR 97309-5018 or fax it
filed if a Change in Status Report is submitted or if
to 503-947-2016. We will notify you within 30 days of
any of the following are changed: your Oregon Busi-
receiving your request whether or not your waiver
ness Identification Number (BIN), Federal Employer
from EFT participation has been granted.
Identification Number (FEIN), business name, busi-
What if I use a payroll service, certified public ac-
ness address, EFT contact person, telephone number,
countant (CPA), bookkeeper, or other service pro-
fax number, or e-mail address. Depending on the
vider for my payroll? You may still enroll in our EFT
type of change, we may need to lock you out of the
program, but must complete a Power of Attorney and
WebPay and TelePay systems.
Declaration of Representative form. You can download
this form from
Payment options
docs/800-005fill.pdf.
What are the two payment options? The two pay-
ment options are ACH debit and ACH credit. Each
Registration
method has its own program guide. This is the ACH
How do I register for the EFT program? To register
debit program guide. You can get the ACH credit pro-
for the ACH debit method, you must first have a cur-
gram guide from
rent active business registration with the department
eft.shtml or by calling our EFT Help/Message Line,
and an Oregon Business Identification Number (BIN)
503-947-2017.
that is open and active for combined payroll taxes.
• ACH Debit (Automated Clearing House Debit)
Next, you must complete the ACH Debit Autho-
rization Agreement and Application form included
There is no cost to you. No software. No hardware.
in this guide. Return your completed form to: EFT
No transmission charges. You initiate the transmis-
Coordinator, Oregon Department of Revenue, PO Box
sion of your tax payment through either a secure
14725, Salem OR 97309-5018 or fax it to 503-947-2016.
internet application or a touchtone telephone.
Be sure to include your Oregon BIN on any cor-
Under this option, you authorize the State of Or-
respondence with the department regarding EFT
egon to electronically transfer tax payments from
payments.
your financial institution into the state’s financial
institution. You make the payment by signing
Changes
into a secure internet application or by calling a
toll-free telephone number sponsored by the Or-
What do I do if I change financial institutions or need
egon Department of Revenue. To avoid penalty
to change the payment method I originally selected?
and interest charges for late payments, you must
Obtain a new Authorization Agreement and Appli-
initiate the payment at least one banking day
cation form and advise us of your change. All infor-
prior to the due date (if you are a one-banking
mation requested on the form must be provided for
day depositor, you can initiate your deposit on
any change you are making.
the due date). You may initiate a payment up to
My financial institution notified me they are chang-
45 banking days prior to the due date by indicat-
ing my account number. What do I need to do? From
ing the payment date.
time to time, financial institutions may find a need to
change account numbers, routing numbers, or other
Prior to the first debit transfer, the Department of
information. If this happens, you need to inform the
Revenue needs some information. We will need
department of the change. Complete a new Autho-
your Oregon Business Identification Number
rization Agreement and Application form advising
(BIN), your financial institution’s routing number,
us of the change. We will need to put a stop on EFT
and the account number you wish to debit. You
transactions until we can process your changes. It will
must provide this information on the ACH Debit
take the department about three weeks to make this
Authorization Agreement and Application form.
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