Blank Texas 74 221 PDF Form Get Texas 74 221 Here

Blank Texas 74 221 PDF Form

The Texas 74 221 form is a document used by taxpayers in Texas to authorize direct deposit for their tax refund payments. This form facilitates the electronic transfer of funds from the State of Texas to the taxpayer's chosen financial institution. By completing this form, taxpayers can ensure a smooth and efficient process for receiving their refunds.

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The Texas 74-221 form is an essential document for taxpayers in Texas who wish to receive their tax refunds via direct deposit. This form allows individuals and businesses to authorize the Texas Comptroller of Public Accounts to deposit their tax refund payments directly into their bank accounts. It requires key information, such as the taxpayer's 11-digit Texas taxpayer number, mailing address, and contact details. Taxpayers must also specify the type of tax refund they are claiming by marking the appropriate boxes. The form includes sections for new account information, changes to existing accounts, and even cancellations. It is crucial to provide accurate banking details, including the routing number and account number, to ensure a smooth transaction. Additionally, if the payments are to be sent to a financial institution outside the United States, specific verification steps must be followed. Completing the 74-221 form correctly helps taxpayers avoid delays and ensures that they receive their refunds in a timely manner.

Texas 74 221 Preview

74-221 (Rev.9-15/12)

Tax Refund Direct Deposit Authorization

This form may be used by taxpayers receiving tax refund payments from the State of Texas.

Taxpayer Information

Enter your 11-digit Texas taxpayer number

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION

Mailing address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

Business name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*7422100W091512*

*7422100W091512*

* 7 4 2 2 1 0 0 W 0 9 1 5 1 2 *

For Comptroller’s use only

Business phone (Area code and number)

ext.

State

ZIP code

 

 

Tax Type (Required)

SECTION 2

Place an X beside the appropriate tax type(s).

Cigarette/Tobacco (T88)

Crude Oil (T36)

Diesel/Motor Fuel Claim (T00)

Diesel/Motor Fuel Tax (T90)

Franchise (T13)

Hotel (T75)

IFTA (T56)

Insurance Maintenance (T72)

Insurance Premium (T71)

CNG / LNG (T90)

Mixed Beverage Sales (T63)

Mixed Beverage Gross Receipts (T73)

Motor Vehicle Rental (T15)

Motor Vehicle Sales (T00)

Natural Gas (T37)

Sales (T26)

Seller Finance (T70)

Other:

 

 

Other:

 

 

 

Transaction Type

SECTION 3

New setup (Sections.1,.2,.3,.4,.6.and.7)

Change inancial institution (Sections.1,.2,.3,.4,.5,.6.and.7) Change account number (Sections.1,.2,.3,.4,.5,.6.and.7)

Change account type (Sections.1,.2,.3,.4,.5,.6.and.7) Cancellation (Sections.1,.2,.3.and.7)

New Account Information (Setups and Changes) (Completion.by.inancial.institution.is.recommended.)

SECTION 4

Financial institution name

Routing transit number (9 digits)

Financial representative name (optional)

Financial representative signature (optional)

 

 

 

 

 

 

City

 

 

 

 

 

 

 

 

 

 

State

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Customer account number (maximum.17.characters)

 

 

 

 

 

 

 

 

 

Type of account

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Checking

Savings

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Title (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone number (optional)

 

 

 

 

 

 

 

 

 

 

Date (optional)

ext.

Existing Account Information (Changes Only)

5

Routing transit number (9 digits)

 

 

 

 

 

 

 

Customer account number (maximum.17.characters)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Type of account

SEC

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Checking

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

International Payments Veriication (Mandatory)

6

Please note: Your direct deposit will not be set up if box is not checked.

 

 

SECTION

 

 

 

Will these payments be forwarded to a inancial institution outside the United States?

YES

 

 

. If."YES,".also.complete.the.ACH.(Direct.Deposit).Payment.Destination.Conirmation.(Form.74-227).

 

 

 

 

 

Savings

NO

Authorization for Setup, Changes or Cancellation (Required)

SECTION 7

I authorize the Texas Comptroller of Public Accounts to deposit my payments from the state of Texas to my inancial institution electronically. I understand that the Texas Comptroller of Public Accounts will reverse any payments made to my account in error.

I further understand that the Texas Comptroller of Public Accounts will comply at all times with the National Automated Clearing House Association's rules. (For.further.information.on.these.rules,.please.contact.your.inancial.institution.)

Authorized signature

Printed name

Date

 

 

 

Form Return Information

SECTION 8

Please return your completed form via mail or FAX to:

 

Texas Comptroller of Public Accounts

Help line: 512-936-8138

Fiscal Management – Direct Deposit Program

FAX: 512-475-5424

P.O. Box 13528

 

Austin, TX 78711-3528

 

Form 74-221 (Back)(Rev.9-15/12)

Instructions for Tax Refund Direct Deposit Authorization

You have certain rights.under.Chapters.552.and.559,.Government.Code,.to.review,.request.and.correct.information.we.have.on. file.about.you..To.request.information.for.review.or.to.request.error.correction,.use.the.contact.information.on.this.form.

Section 1: Taxpayer Information

Enter Texas taxpayer number, business phone, business/payee name and enter payee contact information.

Section 2: Tax Type

Place an "X" in the appropriate box(s) to indicate type of tax refund.

Section 3: Transaction Type

Select the appropriate type of direct deposit transaction.

Section 4: New Account Information (Needed for setups and changes)

Completion by financial institution is recommended.

Important: Your direct deposit account information may be different from what is printed on your checks. It is recommended that you contact your financial institution to confirm your direct deposit account information.

Prenote Test:

A prenote test will be sent to your financial institution for the account information provided. The prenote test is for a period of six banking days, and it is to verify your account information. If no further action is required by your financial institution, your direct deposit information will become effective when the six banking day prenote time frame has expired.

Section 5: Existing Account Information (Needed for changes to existing account information)

When requesting a change to your existing direct deposit account information, you must complete Section 5 with the existing account information for verification purposes. This measure will help the paying state agency verify accuracy of the requested change.

Any change to banking information begins a prenote test period. See explanation in Section 4, above.

Section 6: International Payments Veriication

Check "YES" or "NO" to indicate if direct deposit payments to the account information designated in

Section 3 of this form will be forwarded to a financial institution outside the United States.

If "YES," also complete the ACH (Direct Deposit) Payment Destination Confirmation (Form 74-227).

Section 7: Authorization for Setup, Changes or Cancellation

Must be completed in its entirety, and no alterations to the authorization language will be accepted.

Document Specs

Fact Name Details
Form Purpose This form authorizes direct deposit for tax refund payments from the State of Texas.
Governing Law The form is governed by Texas Government Code, Chapters 552 and 559.
Taxpayer Information Taxpayers must provide their 11-digit Texas taxpayer number and contact information.
Tax Types Taxpayers can select multiple tax types, including Cigarette, Franchise, and Sales taxes.
Transaction Types Options include new setups, changes to financial institutions, or cancellations.
Financial Institution Details Taxpayers must provide the financial institution's name and routing transit number.
International Payments A "YES" or "NO" response is required to indicate if payments will go to an institution outside the U.S.
Authorization Requirement Taxpayers must authorize the Texas Comptroller to deposit payments electronically.
Prenote Test A prenote test verifies account information and lasts for six banking days.
Form Submission The completed form can be returned via mail or fax to the Texas Comptroller's office.
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