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Authorization for Bank Draft Installment Agreement

This legal notice is sent to complete the authorization to pay an Installment Payment Agreement by bank draft. You must sign and return the notice within 15 days of the date on the notice.

Failure to sign and return the Authorization notice voids the pending agreement.

About Your Notice

What should I do?
Where can I get more information?

Common Questions

When will my first payment be drafted?
What if I need to make a change?

 

What should I do?

Sign and return the entire notice within 15 days of the date on the notice. If the Department does not receive the notice within 15 days, your agreement will automatically be in default.

If your installment payment agreement goes into default, the Department may begin forced collection actions immediately. Examples of forced collection actions could include:

  • Deducting 10% of your wages paid before deductions
  • Freezing funds in your bank account
  • Seizing personal or business assets

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Where can I get more information?

For more information, review the Installment Payment Agreement page. If there are additional questions, call 1-877-252-3252.

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When will my first payment be drafted?

The first payment draft date is listed under the heading Important Terms and Conditions of This Agreement.

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What if I need to make a change?

Any changes to your agreement must be made 10 business days before the Next Installment Due Date listed.

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