Form 78-004 - Application For Bulk Filing - Iowa Department Of Revenue

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Application for Bulk Filing
https://tax.iowa.gov
This application is for Service Providers and Transmitters to access and use Iowa Department of
Revenue’s (IDR) bulk filing option. Please provide the information requested below and submit by
fax to Registration Service at 515-281-3906 or mail to:
Registration Services
Iowa Department of Revenue
PO Box 10470
Des Moines IA 50306-0470
Upon receipt of the completed application, IDR will send you a letter with more information about the bulk
filing option. We will also send you a Business eFile Number (BEN) that you will need to access the eFile and
Pay System. If you already have a BEN, we will not issue you a new one. You will use your existing
BEN to facilitate bulk filing. Additional information about the bulk filing option can be found on our website
at https://tax.iowa.gov.
Legal Name
Mailing Address
City
State
ZIP
Federal Employer Identification Number (FEIN) or SSN if sole proprietor
Contact Name
Contact Phone
Contact Fax
Contact Email
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 an IA 2848 Power of
Attorney to the above party to act on behalf of the taxpayer regarding tax matters with IDR or allow the
above party to act as an agent of IDR.
_______________________________________________________
Name of Owner, Officer, Partner or Responsible Party
_______________________________________________________
Signature of Owner, Officer, Partner or Responsible Party
______________________________
Date
78-004 (1/20/17)

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