Electronic Payroll Tax Banking Info -

Complete this form to indicate the bank account you would like us to use to pay your payroll taxes when they are due. Wagner Tax & Accounting will never set up or pay a payroll tax payment on your behalf without advance notification, including the amounts and date(s) that the payment(s) will be processed.

Payroll Tax Payment Banking Account

Bank Acct For Electronic Payroll Tax Payments

Your Company Name

First & Last Name Of Person On Account

Type Of Bank Account

Consumer Checking (Personal)

Business Checking

Other

Please Choose One

Bank Name

Bank Account Number

Bank Routing Number

Use Routing Number For Electronic Payments Usually the 9 digit routing number on a Business Ck.

Your Cell Phone Number

Your Email Address

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.

VOIDED CHECK

Maximum file size: 516MB

Please attach the most recent copy of a voided check so that the payroll clerk can verify all bank aba numbers to avoid electronic errors when paying your payroll taxes.

If you are human, leave this field blank.