Form Eft-1 - Authorization Agreement For Electronic Funds Transfer (Eft) Page 2
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1
2FORM EFT-1
Page 2
(REV. 2012)
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
If you wish to use Method II, Form EFT-1
Method II — ACH Debit
must be signed by an owner, partner or member,
Please make a copy of your application for
Check the box for Method II if you wish to
fiduciary, or officer who is authorized to sign
your records.
pay by ACH Debit. Please provide your complete
checks drawn on the account identified on the
bank information and attach a voided check.
For more information, see Tax Information
form.
Release (TIR) No. 95-06, “Questions and Answers
If you will be paying for more than one tax type
on Paying Taxes by Electronic Funds Transfer;”
using the same bank account and same HTIN,
IMPORTANT INFORMATION
TIR No. 99-01, “Filing of Tax Returns Required by
only one Form EFT-1 should be completed. You
If you checked Method II or Method III,
Taxpayers Who Pay Taxes by Electronic Funds
may pay for any of the taxes listed on the form by
you will receive a confirmation letter in the mail
Transfer (EFT);” and TIR No. 2004-01, “Act 113,
EFT even if you do not exceed $100,000 for that
after you file Form EFT-1. The letter will include
Session Laws of Hawaii 2004, Relating to Income
particular tax type ($40,000 for withholding taxes).
instructions for how to make a payment using
Tax Withholding.”
If you will be using more than one bank
your chosen method. No ACH Debit or ACH
PENALTIES.
Section
231-9.9,
Hawaii
account or HTIN, please complete a Form EFT-1
Credit EFT payments should be attempted before
Revised Statutes (HRS), imposes a penalty of
for each account or HTIN you will be using.
the confirmation letter is received.
2% of the amount of the tax due if those who
The bank information can be obtained from
Method II applicants will also receive their
are required to make payments by EFT do not
your bank or at the bottom of the check from the
access code with the confirmation letter. The
do so on or before the date prescribed without
account you wish to be debited.
personal identification number (PIN) will be
reasonable cause. This is in addition to any other
mailed under separate cover from the data
Account number should not exceed 17 digits.
penalties. Also, section 40-35.5, HRS, allows the
collection center.
Department of Taxation to assess a $25 service
Transfer/Routing Number requires 9 digits.
Method III applicants should be aware that
fee on electronic funds transfer payments that
Omit hyphens in your bank numbers.
the Department may withdraw its approval for
are dishonored for any reason. This service fee
Please remember to attach a voided check
use of ACH Credit for failure to conform to the
cannot be waived.
from the bank account you want debited.
requirements for ACH Credit transactions.
SPECIFIC INSTRUCTIONS
Method I applicants will not be sent a
Method III — ACH Credit
confirmation letter in the mail. After submitting
Part I
Taxpayer Information
—
Check the box for Method III if you wish to pay
your Form EFT-1 to notify us of your intent to file
by ACH Credit.
All taxpayer information must be completed
and pay using our Electronic Services website,
and must match the taxpayer information on file
Some
financial
institutions
offer
ACH
you must register for an E-File account at www.
with the State Department of Taxation.
origination services. Contact your bank to
ehawaii.gov/efile or the Department’s Internet
determine what ACH origination services it offers
Bulk
Filing
website
at
Part II
Method of EFT Payment
—
and the costs of ACH Credit service. You cannot
bulkfile. Afterwards, you will receive an e-mailed
use Method III unless your bank can initiate
confirmation of your registration.
Check the applicable box to indicate your
transactions in the CCD+TXP format.
method of EFT payment.
You must submit a Form EFT-1 if you wish
to change from one ACH payment method to
Please remember that if you use Method III,
Method I — Payment through the State
the Department of Taxation is not responsible for
the other. You must continue making your tax
the successful completion of EFT transactions
payments through EFT using the method in use
of
Hawaii
Department
of Taxation
that are required by law. Furthermore, the
until you receive confirmation authorizing the
Electronic Services Website or Internet
Department will not pay any costs your financial
change and the effective date of the change.
Bulk Filing Website
institution may charge you for its services.
Check the box for Method I to notify the
If you have any questions, please contact the
Part III
Changing Bank Information
—
State of Hawaii Department of Taxation that
Department of Taxation’s Electronic Processing
you will make your tax payments through the
for ACH Debit Method
Section at:
Department’s Electronic Services website or
Provide your complete bank information
E-mail: Tax.Efile@hawaii.gov
Internet Bulk Filing website.
for your old bank account and your new
Telephone: 808-587-1740
At the Electronic Services website, you have
bank account. If you are changing your bank
the option of paying by credit card or by electronic
information and the effective date of change is
Fax: 808-587-1488
check (eCheck). A processing fee applies for all
noted on Form EFT-1, the change will be done no
Mail the completed Form EFT-1 to:
payments made through the Electronic Services
earlier than that date.
website. Credit card payments are also subject to
Please remember to attach a voided check
EFT Program
a 2.25% service fee on the payment amount. You
from the new bank account you want debited.
Hawaii Department of Taxation
are responsible for these fees. All fees are non-
waivable. ‘Payments made through the Internet
P.O. Box 259
Signature
Bulk Filing website are ACH Debit transactions.
Honolulu, HI 96809-0259
Form EFT-1 must be signed by an owner,
A processing fee will apply to each transaction
partner or member, fiduciary, or officer.
made through the Internet Bulk Filing website.
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