770PMT

Form 770PMT - Virginia Fiduciary and Unified Nonresident Payment Coupon

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Form 770PMT Instructions

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Status: NOT FILED

770PMT

For Period

Filing Basis Calendar Fiscal

For Taxable Year

Fiduciary Form 765 Unified Nonresident

Account Number

32-

FEIN

F-001

Demographics

Name of Estate, Trust or Unified Filer

Name and Title of Fiduciary or Unified Filer

Mailing Address

City

State

ZIP

770PMT

Do not submit Form 770PMT if no amount is due.

Amount of this Payment

Payment

Please enter your payment details below.

If your bank requires authorization for the Department of Taxation to debit a payment from your checking account, you must provide them with this Debit Filter number: 1546001745

At present, Virginia TAX does not support International ACH Transactions (IAT). Click IAT Notice to review the details.

Please note, a $35 fee may be assessed if your payment is declined by your financial institution as authorized by Code of Virginia §2.2-614.1. Visit our website for more information.

Bank Account Information

Bank Routing Number

Bank Name

Bank Account Number

Re-Enter Bank Account Number

Payment Information

Payment Amount

Payment Date Today

Schedule Payment For:

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Payment Information

Bank Routing Number

Bank Account Number

Payment Amount

Payment Date Once confirmed this date cannot be modified

Electronic Signature (required)

Taxpayer's Name Authorizing Payment

Daytime Phone Number

Federal banking regulations have imposed additional reporting requirements on all electronic banking transactions that directly involve a financial institution outside of the territorial jurisdiction of the United States at any point in the process. These are called International ACH Transactions (IAT).

At present, TAX does not support IAT.

If an international transaction is processed by TAX as a domestic transaction, it may be rejected by the taxpayer's bank, subjecting the taxpayer to late penalties.

By instructing TAX to process the electronic banking transaction, you are certifiying that the transaction does not directly involve a financial institution outside of the territorial jurisdiction of the United States at any point in the process.

If any transaction is IAT, payment will need to be made using a paper check or by ACH Credit. For information about ACH Credit, please refer to TAX's Electronic Payment Guide.

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Form 770PMT - Virginia Fiduciary and Unified Nonresident Payment Coupon

770PMT

Payment

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Important Notice Regarding Electronic Banking Transactions

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