Payment Request For Your CA Corp/LLC Tax This Payment Request is For Corporations & LLC Partnerships Payment Request (CA Franchise Corp/LLC Tax) Your Name or Name of Business Entity Your Name or LLC/CORPORATE/PARTNERSHIP NAME * Must Match Tax Returns What Is This Tax Payment For * Corporation Taxes LLC Taxes (Multi-Member LLC) SMLLC (Single Member LLC) BUSINESS ADDRESS * BUSINESS ADDRESS BUSINESS ADDRESS BUSINESS ADDRESS City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal EMAIL ADDRESS * CELL PHONE * EIN (Federal Id Number) * If unknown and Wagner Has Previously Filed Returns Type "On File" YOUR NAME (Tax Matters Person Responsible For this Request) First & Last Name WHAT YEAR CA CORP/LLC TAX ARE WE PAYING? * 2022 2023 2024 Not Sure (Ask My Preparer) Corporations & LLCs pay an annual CA Franchise Tax minimum of $800 depending on your Business Income. This minimum tax is considered late if paid after the original due date of the return which is generally March 15th. This Ext does not extend that Pmt. Please Confirm Your Request I Request & Direct Wagner Tax To Setup & Process An Electronic Payment Using the Account Info Below. (Wagner Tax will email confirmation.) If you are requesting Wagner Tax to make a tax payment on your behalf, you must successfully submit this form no later than 5 pm on the deadline day. Wagner Tax cannot be held responsible if the payment fails for any reason at the time of setting up the payment. By Clicking this box you are granting authorization for us to attempt a payment on your behalf. Please Choose Pmt Type Debit (Bank Account) Credit Card/Atm Debit Card This will be used to pay your taxes in accordance with the schedule discussed with your preparer & used to pay the Fee associated with this service administered by Wagner Tax ($45) Name Of Authorized Person As It Appears On Card Or Bank Account Card Number or Bank Account Number Please be sure this information is correct. Type Of Bank Account (If Using Bank Account) Personal Checking/Savings Consumer Business Account Bank Routing Number Make sure to use the correct bank routing number for payments Expiration Date (If Using Card) Billing Zip Code (If Paying With Card) 3 Digit Code (CVV) If Using Card 3 or 4 digit code on back of card ELECTRONIC SIGNATURE Please Type Your Your Signature — An "electronic signature" is a method of signing an electronic form that— (A) identifies and authenticates a particular person as the source of the electronic signature; and (B) indicates such person's authorization and approval. NOTES By submitting this form you are requesting us to Make a tax payment(s) on your behalf according to the schedule discussed with your preparer. Fees Associated with FTB or IRS for making an electronic payment are not the responsibility of Wagner Tax and by this authorization, you approve and agree to pay any and all governmental fees required to file and Pay online. If you are human, leave this field blank.