- 2 -
|
Taxpayer’s name
Step 5: Complete the following financial institution information for debit withdrawals
12 15 Check one: Business or Individual/Consumer
Financial institution’s name
13 16 Check one: Checking or Savings
Name on account
14 17
Account number Routing transit number
Step 6: Sign and complete
The signature of the taxpayer, authorized officer, or partner is required, as well as the title and date (even if you are using a designated
agent).
For the debit payment method, I agree and understand that I am authorizing the Illinois Department of Revenue (IDOR) to make withdrawals
from the financial institution account listed in Step 5 when payments are scheduled.
Under penalties of perjury, I state that I have examined this form and to the best of my knowledge it is true, correct, and complete. The Illinois
Department of Revenue is authorized to use this information in accordance with the Department of Revenue Law of the Civil Administrative
Code of Illinois and all applicable Illinois tax acts. This agreement shall remain in force until the Department receives written notification from
the taxpayer.
/ /
Signature of taxpayer, authorized officer, or partner Title Date
Form EFT‑1 Instructions
General Information Specific Instructions
What payment methods require that I complete Step 1: Complete the following information
Form EFT‑1? Check the payment method you wish to use and whether this is an
Certain ACH Debits - initial registration or if you are changing information you previously
provided. Attach additional sheets if necessary.
• Pay-by-phone debit method: This option is available for most
tax accounts. You must complete a separate Form EFT-1 for Step 3: Complete designated agent or contact
each account from which you will make payments. person information
• Cigarette tax stamp purchasers: You are required to use the If a designated agent will be transferring payments, complete Step 3.
debit payment method for your cigarette tax stamp orders. If the designated agent is completing Form EFT-1 on behalf of a
You must complete Form EFT-1 for the account from which taxpayer, the taxpayer must provide a signature in Step 6, unless a
you will make payments. signed Form IL-2848-E is kept in the designated agent’s books and
records.
IMPORTANT: Do not complete Form EFT‑1 to make the following
Note: If the pay-by-phone option will be used and the bank account
electronic payments: 1) debit using MyTax Illinois at tax.illinois.gov; 2)
is the designated agent’s, an authorized officer of the agent
direct file debit; or 3) credit card option for Illinois Individual Income
must sign on Step 3, Line 11, to authorize us to debit that account.
Tax (follow the instructions at tax.illinois.gov and please note a
convenience fee will be assessed for each credit card transaction). The contact person should be the person who will be initiating and
making the payment transfer. Include the telephone number, fax
Where do I send my completed Form EFT‑1? number, and email address.
Mail to: ELECTRONIC PAYMENTS SECTION
ILLINOIS DEPARTMENT OF REVENUE
PO BOX 19015
SPRINGFIELD IL 62794‑9015
Fax number: 217 524‑8282
What if I need help?
If you encounter any problems or have any questions regarding
ACH payments, please contact the Electronic Payments Section at
217 782‑6257 or REV.taxpay@illinois.gov.
This form is authorized as outlined under the tax or fee Act related to the tax or fee for which this form is filed. Disclosure of this
information is required. Failure to provide information may result in this form not being processed and may result in a penalty.
Page 2 of 2 Printed by authority of the state of Illinois - Web only, One copy EFT-1 (R-10/23)
Reset Print
|