Form EFT-1 "Authorization Agreement for Electronic Funds Transfer (Eft)" - Hawaii

What Is Form EFT-1?

This is a legal form that was released by the Hawaii Department of Taxation - a government authority operating within Hawaii. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2017;
  • The latest edition provided by the Hawaii Department of Taxation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form EFT-1 by clicking the link below or browse more documents and templates provided by the Hawaii Department of Taxation.

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Download Form EFT-1 "Authorization Agreement for Electronic Funds Transfer (Eft)" - Hawaii

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Clear Form
FORM
DO NOT WRITE OR STAPLE IN THIS SPACE
STATE OF HAWAII––DEPARTMENT OF TAXATION
EFT-1
AUTHORIZATION AGREEMENT FOR
(REV. 2017)
ELECTRONIC FUNDS TRANSFER (EFT)
Declaring EFT Method to:
ACH Debit
ACH Credit
DOTAX E-Services
Adding Tax Type
Changing bank information for ACH Debit - Complete Part I below and Part III on page 2.
PART I
Taxpayer Information
Taxpayer’s Name
Trade Name or Doing Business As (DBA) Name
FEIN/SSN
C/O
Contact Person
Mailing Address (Number and Street)
Contact Person Telephone Number
(
)
City or Town, State, and Postal/ZIP Code
Contact E-mail Address
Please indicate the tax types that you will be paying by EFT by checking the appropriate tax type box(es) below. Enter the identification number for each tax
type in the corresponding box. Note: The Department of Taxation (DOTAX) will not require an employer whose withholding liability exceeds $40,000 to pay
by EFT if such employer is not required to remit their federal employment taxes electronically.
Tax Type
Tax Type Code
Hawaii Tax I.D. No.
Tax Type
Tax Type Code
Hawaii Tax I.D. No.
General Excise and Use
04610
Fuel
05007
Withholding
01130
Liquor
06418
Transient Accommodations
07420
Cigarette and Tobacco
07219
Rental Motor Vehicle, Tour Vehicle
Individual Income
01311
& Car-Sharing Vehicle Surcharge
20070
Corporation
02230
Public Service Company (PSC)
15095
Fiduciary Income
01740
PSC Installment (FP-1)
15077
Individual Estimated Income
01201
Franchise
02287
Corporation Estimated Income
02103
Estates and Trusts Estimated Income
Franchise Installment (FP-1)
02177
01205
Part II
Method of EFT Payment. Check only one box to indicate your method of EFT payment.
Method I — Payment through the Hawaii DOTAX Electronic Services Website.
DOTAX is hereby notified that the above-named taxpayer will
make payments through one of the options listed on DOTAX’s Electronic Services website at tax.hawaii.gov/eservices/.
Reminder: Attach voided check.
Method II — ACH Debit (Payment through the telephone). Complete the bank information below.
If you have more than one Hawaii Tax Identification Number (HTIN) for a tax type you are paying by EFT, you must submit a separate Form EFT-1
for that HTIN. DOTAX is hereby authorized to present debit entries which I or my authorized agent originates to the bank account identified below
and the bank is authorized to debit such account for the tax(es) identified above.
Account Name
Account Number (Not to exceed 17 digits)
Bank Name
Transfer/Routing Number (Requires 9 digits)
Method III — ACH Credit.
DOTAX is hereby requested to grant approval for the above named taxpayer to initiate ACH Credit transactions to the State of Hawaii’s bank
account. These payments must be in the NACHA CCD+ format using the Tax Payment Convention (TXP).
If you have additional HTIN, please list:
DECLARATION
The above authority is to remain in effect until EFT payments are no longer required by statute; until I am notified in writing that the State of Hawaii Department of Taxation has
withdrawn its approval for use of the ACH Credit method (if Method III is checked); or, if I am a voluntary participant, until the State of Hawaii Department of Taxation and I mutually
agree to terminate my participation in the EFT program.
Signature of Owner, Partner or Member, Fiduciary, or Officer
Title: Owner, Partner or Member, Fiduciary, or Officer
Date
Print Name of Owner, Partner or Member, Fiduciary, or Officer
FORM EFT-1
Clear Form
FORM
DO NOT WRITE OR STAPLE IN THIS SPACE
STATE OF HAWAII––DEPARTMENT OF TAXATION
EFT-1
AUTHORIZATION AGREEMENT FOR
(REV. 2017)
ELECTRONIC FUNDS TRANSFER (EFT)
Declaring EFT Method to:
ACH Debit
ACH Credit
DOTAX E-Services
Adding Tax Type
Changing bank information for ACH Debit - Complete Part I below and Part III on page 2.
PART I
Taxpayer Information
Taxpayer’s Name
Trade Name or Doing Business As (DBA) Name
FEIN/SSN
C/O
Contact Person
Mailing Address (Number and Street)
Contact Person Telephone Number
(
)
City or Town, State, and Postal/ZIP Code
Contact E-mail Address
Please indicate the tax types that you will be paying by EFT by checking the appropriate tax type box(es) below. Enter the identification number for each tax
type in the corresponding box. Note: The Department of Taxation (DOTAX) will not require an employer whose withholding liability exceeds $40,000 to pay
by EFT if such employer is not required to remit their federal employment taxes electronically.
Tax Type
Tax Type Code
Hawaii Tax I.D. No.
Tax Type
Tax Type Code
Hawaii Tax I.D. No.
General Excise and Use
04610
Fuel
05007
Withholding
01130
Liquor
06418
Transient Accommodations
07420
Cigarette and Tobacco
07219
Rental Motor Vehicle, Tour Vehicle
Individual Income
01311
& Car-Sharing Vehicle Surcharge
20070
Corporation
02230
Public Service Company (PSC)
15095
Fiduciary Income
01740
PSC Installment (FP-1)
15077
Individual Estimated Income
01201
Franchise
02287
Corporation Estimated Income
02103
Estates and Trusts Estimated Income
Franchise Installment (FP-1)
02177
01205
Part II
Method of EFT Payment. Check only one box to indicate your method of EFT payment.
Method I — Payment through the Hawaii DOTAX Electronic Services Website.
DOTAX is hereby notified that the above-named taxpayer will
make payments through one of the options listed on DOTAX’s Electronic Services website at tax.hawaii.gov/eservices/.
Reminder: Attach voided check.
Method II — ACH Debit (Payment through the telephone). Complete the bank information below.
If you have more than one Hawaii Tax Identification Number (HTIN) for a tax type you are paying by EFT, you must submit a separate Form EFT-1
for that HTIN. DOTAX is hereby authorized to present debit entries which I or my authorized agent originates to the bank account identified below
and the bank is authorized to debit such account for the tax(es) identified above.
Account Name
Account Number (Not to exceed 17 digits)
Bank Name
Transfer/Routing Number (Requires 9 digits)
Method III — ACH Credit.
DOTAX is hereby requested to grant approval for the above named taxpayer to initiate ACH Credit transactions to the State of Hawaii’s bank
account. These payments must be in the NACHA CCD+ format using the Tax Payment Convention (TXP).
If you have additional HTIN, please list:
DECLARATION
The above authority is to remain in effect until EFT payments are no longer required by statute; until I am notified in writing that the State of Hawaii Department of Taxation has
withdrawn its approval for use of the ACH Credit method (if Method III is checked); or, if I am a voluntary participant, until the State of Hawaii Department of Taxation and I mutually
agree to terminate my participation in the EFT program.
Signature of Owner, Partner or Member, Fiduciary, or Officer
Title: Owner, Partner or Member, Fiduciary, or Officer
Date
Print Name of Owner, Partner or Member, Fiduciary, or Officer
FORM EFT-1
FORM EFT-1
Page 2
(REV. 2017)
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
Signature
Please provide your complete bank information
and attach a voided check.
Please make a copy of your application for
Form EFT-1 must be signed by an owner,
your records.
If you will be paying for more than one tax
partner or member, fiduciary, or officer.
type using the same bank account and same
For more information, see Tax Information
If you wish to use Method II, Form EFT-1 must
HTIN, complete only one Form EFT-1. You may
Release (TIR) No. 95-06, “Questions and An-
be signed by an owner, partner or member, fidu-
pay for any of the taxes listed on the form by EFT
swers on Paying Taxes by Electronic Funds
ciary, or officer who is authorized to sign checks
even if you do not exceed $100,000 for that par-
Transfer;” TIR No. 99-01, “Filing of Tax Returns
drawn on the account identified on the form.
ticular tax type ($40,000 for withholding taxes).
Required by Taxpayers Who Pay Taxes by Elec-
IMPORTANT INFORMATION
If you will be using more than one bank ac-
tronic Funds Transfer (EFT);” TIR No. 2004-01,
count or HTIN, please complete a Form EFT-1
If you checked Method II or Method III, you
“Act 113, Session Laws of Hawaii 2004, Relating
for each account or HTIN you will be using.
to Income Tax Withholding;” and Tax Announce-
will receive a confirmation letter in the mail. The
ment 2011-04, “Additional Tax Types Required to
The bank information can be obtained from
letter will include instructions for how to make a
be Paid by Electronic Funds Transfer (EFT).”
your bank or at the bottom of the check.
payment using your chosen method. No ACH
PENALTIES. Section 231-9.9, Hawaii Re-
Debit or ACH Credit EFT payments should be
Account number should not exceed 17 digits.
attempted before the confirmation letter is re-
vised Statutes (HRS), imposes a penalty of 2%
Transfer/Routing Number requires 9 digits.
ceived.
of the tax due if those who are required to make
Omit hyphens in your bank numbers.
Method II applicants will also receive their ac-
payments by EFT do not do so on or before the
Please remember to attach a voided check
date prescribed without reasonable cause. This
cess code with the confirmation letter. The per-
from the bank account you want debited.
is in addition to any other penalties. Also, section
sonal identification number (PIN) will be mailed
40-35.5, HRS, allows DOTAX to assess a $25
under separate cover from the data collection
Method III — ACH Credit
service fee on electronic funds transfer payments
center.
Check the box for Method III if you wish to pay
that are dishonored. This service fee cannot be
Method III applicants should be aware that
by ACH Credit.
waived.
DOTAX may withdraw its approval for use of ACH
Some financial institutions offer ACH origina-
SPECIFIC INSTRUCTIONS
Credit for failure to conform to the requirements
tion services. Contact your bank to determine
for ACH Credit transactions.
Part I
Taxpayer Information
what ACH origination services it offers and the
Method I applicants will NOT be sent a con-
costs of ACH Credit service. You cannot use
firmation letter in the mail. After submitting your
Enter the identification number for the tax
Method III unless your bank can initiate transac-
Form EFT-1 to notify us of your intent to file and
type. If you have more than one Hawaii Tax Iden-
tions in the CCD+TXP format.
pay using our Electronic Services website, you
tification Number (HTIN) for a tax type you are
Please remember that if you use Method III,
must register for an E-File account at tax.hawaii.
paying by EFT, you must submit a separate Form
DOTAX is not responsible for the successful
gov/eservices/. Afterwards, you will receive an
EFT-1 for that HTIN. All taxpayer information
completion of EFT transactions that are required
e-mailed confirmation of your registration.
must be completed and must match the taxpayer
by law. Furthermore, DOTAX will not pay any
information on file with DOTAX.
You must submit a Form EFT-1 if you wish to
costs your financial institution may charge you
change from one ACH payment method to the
Part II
Method of EFT Payment
for its services.
other. You must continue making your tax pay-
Part III
Changing Bank Information
Check the applicable box to indicate your
ments through EFT using the method in use until
method of EFT payment.
you receive confirmation authorizing the change
for ACH Debit Method
and the effective date of the change.
Method I — Payment through DOTAX’s
Provide your complete bank information for
If you have any questions, please contact
Electronic Services Website
your old bank account and your new bank ac-
DOTAX’s Electronic Processing Section at:
count. If you are changing your bank informa-
Check the box for Method I to notify DOTAX
E-mail: Tax.Efile@hawaii.gov
tion and the effective date of change is noted on
that you will make your tax payments through
Telephone: 808-543-6814
Form EFT-1, the change will be done no earlier
DOTAX’s Electronic Services website.
Fax: 808-587-1488
than that date.
Mail the completed Form EFT-1 to:
Method II — ACH Debit (Payment through
Please remember to attach a voided check
from the new bank account you want debited.
EFT Program
the telephone)
Hawaii Department of Taxation
Check the box for Method II if you wish to pay
P.O. Box 259
by ACH Debit (Payment through the telephone).
Honolulu, HI 96809-0259
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