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EFTPS PERSONAL ENROLLMENT 2022.html -- 7k
Congratulations.
Within seven days, you will receive in the mail:
Your PIN
Instructions on how to create an EFTPS Internet password
Please note: We will mail your PIN to the IRS address of record for your employer identification number or social security number enrollment. That address may be different from the contact information you entered.
Your enrollment number is 422511242091517022.
This is important. Print for your records.
If your payment must reach the IRS today to be timely, please visit irs.gov/epay for options.
Personal information
Primary taxpayer Social Security Number:xxx-xx-xxxx
Primary taxpayer name:MICHAEL ROLLINS
Primary taxpayer U.S. phone:(509) 431-8137
Contact information
Name:MICHELE MCKERRIHAN
Country:UNITED STATES OF AMERICA
Address:PO BOX 448
City:EPHRATA
State:WASHINGTON
ZIP:98823
U.S. phone:(509) 717-3038
Financial information
Routing number:125100089WASHINGTON TRUST BANK
Account number:xxxxxx9532
Account type:CHECKING
Authorization agreements
You agreed to this:
Debit Authorization Agreement
Please read the following Authorization Agreement:
By completing the Financial Institution information above, and electronically signing by selecting "Accept" below, I authorize designated Financial Agents of the U.S. Treasury to initiate EFTPS debit entries to the financial institution account indicated above, for payment of federal taxes owed to the
IRS upon request by Taxpayer or his/her representative, using the Electronic Federal Tax Payment System (EFTPS). I further authorize the financial institution named above to debit such entries to the financial institution account indicated above. All debits initiated by the U.S. Treasury designated Financial Agents pursuant to this authorization shall be made under U.S. Treasury regulations. This authorization is to remain in full force and effect until the designated Financial Agents of the U.S. Treasury have received written notification of termination in such time and in such manner as to afford a reasonable opportunity to act on it.
Disclosure Authorization Agreement
Please read the following Authorization Agreement:
I hereby authorize the contact person listed on this form and financial institutions involved in the processing of my Electronic Federal Tax Payment System (EFTPS) payments to receive confidential information necessary to effect enrollment in EFTPS, electronic payment of taxes, answer inquiries and resolve issues related to enrollment and payments. This information includes, but is not limited to, passwords, payment instructions, taxpayer name and identifying number, and payment transaction details. This authorization is to remain in full force and effect until the designated Financial Agents of the U.S. Treasury have received written notification from me of termination in such time and in such manner to afford a reasonable opportunity to act on it.
Authority to Execute an Authorization
If this authorization is signed by a primary taxpayer or on behalf of joint filers, I certify that I have the authority to have payments made from the account identified with the payment option, above, without the secondary taxpayer's authorization. If signed by a representative of the taxpayer, I certify that I have the authority to execute this authorization on behalf of the taxpayer(s) (i.e. authority provided by Form 2848, Power of Attorney and Declaration of Representative, or other power of attorney).
I am signing this agreement by typing my name, social security number, and today's date below.
Electronic signature
Name:MICHAEL ROLLINS
Date:July 15, 2022
Primary taxpayer Social Security Number:xxx-xx-xxxx
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bring into the event’s or task’s description, and then click “Select text to copy” to have the next event or task you create or edit have the document text and link.
