Ftb 3816 Form – Fill Out and Use This PDF

STATE OF CALIFORNIA

FRANCHISE TAX BOARD

ELECTRONIC FUNDS TRANSFER

ELECTION TO DISCONTINUE

OR WAIVER REQUEST

Entities who make an estimated tax or extension payment exceeding $20,000 or whose total tax liability exceeds $80,000 for any income year beginning on or after January 1, 1995, are required to remit all your corporate and franchise tax payments to the Franchise Tax Board by Electronic Funds Transfer (EFT). Failure to comply with EFT requirements will result in the assessment of a penalty.

Section 19011 of the California Revenue and Taxation Code provides that any taxpayer who is required to remit payments to the Franchise Tax Board by EFT may request a waiver of those requirements. The Franchise Tax Board may grant a waiver if it determines that the amounts paid in excess of the threshold amounts were not representative of the taxpayer’s tax liability. In addition, taxpayers not meeting either threshold amount for the prior year may use this form to elect to discontinue making payments by EFT.

To request a waiver or to elect to discontinue making payments by EFT, complete and submit the following. You must remit all payments by EFT until you have been notified that this request has been granted.

Entity Name	Entity Number
Address
City	State				Zip Code

NOTE: If this entity is a member of a unitary group, please attach a schedule showing the names and entity numbers of all other members that are California taxpayers.

If the entity does not meet the following conditions, it is required to file an Authorization Agreement for Electronic Funds Transfer (FTB 3815) with the Franchise Tax Board and to remit all payments by EFT.

The above entity elects to discontinue making payments by EFT because it has not made an estimated tax or extension payment in excess of $20,000 during the current or previous income year; and the entity’s total tax liability reported for the previous income year did not exceed $80,000.

The above entity is requesting a waiver from participation in the EFT program because the amounts paid were not representative of the entity tax liability, as explained below. Please use back side if additional space is needed.

							(		)
	Date			Signature and Title of Representative/Officer			Telephone Number
				Please return this completed form to:
Franchise Tax Board, Electronic Funds Transfer Unit, P.O. Box 942857, Sacramento, CA 94257-0501
		Telephone: (916) 845-4025			FAX: (916) 845-5340

FTB 3816 (REV 11-96) SIDE 1

EFT WAIVER REQUEST

FTB 3816 (REV 11-96) SIDE 2