Form R-20213 - Authorization Agreement For Electronic Funds Transfer (Eft) Of Tax Payment

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R-20213 (7/03)
Electronic
Wouldn’t it be great if you could take care of your tax
There are two ways to pay electronically—debit transfers
payments without all the hassles of writing and mailing
or credit transfers.
checks?
Funds
Debit transfers
You can—with Electronic Funds Transfer (EFT).
To authorize payments, you call the Department’s banking
service, a toll-free number, using either touch-tone
You’re in control with EFT.
Transfer:
automation, personal computer, or operator assistance. You
Payments can’t get lost or delayed in the mail, and you can
specify the amount to be transferred, and the service will
pay when it’s convenient—24 hours a day, 7 days a week.
then transfer that amount from your bank account to the
The call for debit payers must be completed before 1:30
Department’s account. The state pays the transaction cost
p.m. Central Time at least one business day before you
for the debit option.
want your bank account debited. The call is toll-free.
the smart
Credit transfers
EFT is easy.
To authorize payment with a credit transfer, you have your
way to
When you choose the ACH debit method, a phone call is all
bank transfer funds to the state’s bank account.
it takes to authorize payment.
(Supplemental filing information must be sent with your
payment using the ACH standard CCD+ format and TXP
pay your
EFT is secure.
Addendum Record standards. Contact your bank to make
sure they offer ACH origination services.) The cost of each
You have complete control of the movement of your
transaction is charged to you, as the originator of the credit
money.
Louisiana
transfer.
The funds can only be deposited to the State of
Getting started is easy
Louisiana’s bank account.
business
Fill out the form on the back and mail it to us. We’ll send
Your transaction is protected by a security access code.
you an EFT instruction packet. If you’re choosing the debit
transfer option, be sure to include a copy of a cancelled or
taxes
You get a verification number at the end of each call,
voided check from your account.
so your transaction can be tracked.
Remember to send
a copy of your
cancelled or
voided check!
Bank account number
A publication of the
Routing and transit number
Louisiana Department of Revenue

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