Fillable Registration Form ACH Credit Registration Form (City of Columbus)

Fill Online, Printable, Fillable, Blank Registration Form ACH Credit Registration Form (City of Columbus) Form

Use Fill to complete blank online CITY OF COLUMBUS (OH) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Registration Form ACH Credit Registration Form (City of Columbus)

On average this form takes 5 minutes to complete

The Registration Form ACH Credit Registration Form (City of Columbus) form is 1 page long and contains:

  • 0 signatures
  • 4 check-boxes
  • 17 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Columbus

BROWSE CITY OF COLUMBUS (OH) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
CITY OF COLUMBUS
INCOME TAX DIVISION
www.columbustax.
net
ACH Credit Registration Form
ACH Credit Authorization Agreement for Electric Funds Transfer (EFT)
New EFT Account Change Contact Information
Withholding Tax Payment Net Profits Tax Payment
Section I
Taxpayer Account Number
--
Taxpayer Address (number, street, box number)
Daytime Telephone
( )
Taxpayer Address (city, state and ZIP code)
Fax Number
( )
Contact Person
E-Mail Address
Contact Daytime Telephone
( )
Contact Address (number, street, box number)
Contact Address (city, sate and ZIP code)
Section II
I hereby authorize the contact person listed on this form and the financial institutions involved in processing of my payments to receive confidential
information necessary to effect electronic payment of city income taxes, answer inquiries, and resolve issues related to enrollment and payments.
If signed by a corporate officer, partner or fiduciary of behalf of the taxpayer, I certify that I have the authority to execute this authorization on
behalf of the taxpayer. This authorization is to remain in full force until the Income Tax Division of the City of Columbus Auditor’s Office has
received written notification from me of termination in such time as to afford a reasonable opportunity to act on it.
Signature
Print
Title
Date
Bank Name and Address
Bank Contact person
Bank Contact Telephone
( )
Mail or FAX the completed registration form to:
ATTN: ACH Credit Registration
COLUMBUS INCOME TAX DIVISION
77 N. Front Street, 2nd Floor
TH
COLUMBUS, OH 43215
FAX Number: (614) 645-7193
Rev. 2/8/16
EFT1 (REV 07/14/08) SIDE 2
Instructions for Completing the ACH Credit Authorization Form
General
Please type or print clearly. Return the authorization form to the Columbus Income Tax Division within
15 days form the date you receive it.
By checking the appropriate box, you must use this form to:
•
Register for participation in the ACH credit program;
•
Receipt of the Electronic Funds Transfer Taxpayers Guide which includes bank account numbers
and file layout specifications for ACH Credit remittances;
•
Assignment of a Withholding or Net Profits or both ACH Credit Registration Numbers to be
included in Field 10 (TXP 10) of the TXP segment;
•
Change contact information.
SECTION I
Complete all of the blocks in this section.
Your Taxpayer Account Number is the city income tax account number assigned by the Columbus
Income Tax Division.
SECTION II
Complete all of the blocks in this section. Signature is required.
Important Information:
1.
If you do not have an existing city income tax account, you are required to enroll on line at our
web site at
www.columbustax.net
.
2.
File layout specifications will be mailed to you once your registration form has been accepted.
3.
The following electronic payment options are available: CCD+ (Cash Concentration and
Disbursement Plus Addenda) and CTX (Corporate Trade Exchange).
.
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Registration Form ACH Credit Registration Form (City of Columbus)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 2 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document