Tax Type: Businesses may use electronic funds transfers
(EFT) to le and pay Maryland withholding, motor fuel and
corporate income taxes. Accepted corporate forms are 500,
500D and 500E only. Forms 510, 510D, 510E for Pass-
through Entities are NOT accepted.
Section A – This section must be completed by ALL
• Business name - required.
• Maryland Central Registration Number - if registered.
• Federal Employer Identication Number - required.
• Motor Fuel Tax Account Number - if applicable.
• EFT contact person: The primary contact person
should be someone within your company who will be
directly involved in all phases of the EFT registration
process, system implementation, and the payment of
the tax. Instructions will be mailed to the contact person
designated on the agreement. You also should designate a
secondary contact person.
• Address: Indicate the mailing address to be used for
correspondence regarding electronic funds transfer.
• Telephone number: Indicate the telephone number(s)
for the EFT contact person.
• Signature of owner, partner or ocer: Authorized
signature of owner, partner or ocer of the company.
Section B – Complete this section only if you are choosing
the ACH Debit option.
• Bank name: Name of the bank you will be using for
electronic funds transfers.
• Bank address: Indicate the address of the bank branch
you will be using.
• Bank account number: The account number from which
the State will draw debit entries.
• Type of account: Check the appropriate box for the type
of account (savings or checking) you will be using for
electronic funds transfer.
• Bank routing transit number: Your bank’s nine-digit
routing/transit number is required.
• Signature of owner, partner or ocer: Authorized
signature of owner, partner or ocer of the company. This
signature will authorize the Comptroller of Maryland to
present debit entries.
Section C – Complete this section only if you are choosing
the ACH Credit option.
Name and address of the bank: Provide the name and
address of the bank you will be using for electronic funds
Printed name and signature of bank representative
(include bank representative’s telephone number): You cannot
use the ACH Credit option unless your bank can initiate
transactions in this format.
Mail this completed form to:
Electronic Funds Transfer Program
P.O. Box 549
Annapolis, MD 21404-549
Electronic Funds Transfer Program telephone number 410-260-7980 • Fax: 410-260-6214
Hearing impaired users call via Maryland Relay at 711 in Maryland
Instructions for Form EFT
ACH CREDIT OPTION
To use the ACH Credit option, you must rst contact your bank to
determine if your bank oers ACH Origination. Have your bank
complete the specic portion of the Authorization Agreement
(Form EFT) as verication that your bank can conform to these
standards. Also, complete Section A and Section C before
returning the form to the Electronic Funds Transfer Program
Supplemental ling information must be sent with your payment
using the ACH standard CCD+ format and the TXP addenda
record. The Cash Concentration or Disbursement (CCD) is
the most basic form of ACH payment. The CCD format can be
processed by all ACH-member banks. The TXP addenda record
allows the format to carry additional characters of payment-
related data. The TXP will be used for tax registration, tax type
code and tax period end date.
You will initiate the credit transaction through your bank to the
State’s bank account for the amount of your tax payment.
An ACH origination charge from you bank will be incurred by you
if you select the ACH Credit option.
Important characteristics of the ACH Credit transactions
• Credit transactions require you to enter all payment related
data in the standard CCD+ TXP.
• The costs of the ACH Credit transactions are incurred by
• You are responsible for your own proof of payment.
ACH DEBIT OPTION
To use the ACH Debit option, complete Section A and Section
B before returning the form to the Electronic Funds Transfer
After we receive the Authorization Agreement, the State’s Service
Bureau will mail you specic instructions on the initiation of
Electronic Funds Transfer. You authorize each payment amount
to be transferred from your bank account to the State’s bank by
using a toll-free number.
After you complete the call, the Comptroller of Maryland is
responsible for the successful completion of the transaction. The
State’s Service Bureau will provide you with a verication code
indicating that you have completed the necessary steps for the
initiation of the Electronic Funds Transfer.
Important characteristics of the ACH Debit transactions are:
Just place a toll-free call to make your tax
It’s predictable Only the amount you specify will be
transferred to the State’s bank account on
the date specied.
It’s accurate The Service Bureau will provide a verication
code as your proof of payment.
It’s secure Only you will have the password required to
initiate a payment.
It’s exible Extensive editing and correction data can
be performed before the transaction is
completed. This means that transactions are
virtually error free.
It’s inexpensive Costs for an ACH Debit are primarily borne by
the State. Your bank may have a nominal fee
for processing the debit, but it is generally
the same cost as a check, or less.