CDTFA-400-XML (FRONT) REV. 3 (11-21)                                                                                        STATE OF CALIFORNIA 
APPLICATION FOR DIRECT TRANSMISSION OF TAX RETURNS                                                                          CALIFORNIA DEPARTMENT OF
                                                                                                                            TAX AND FEE ADMINISTRATION

New                Revised                Reinstatement
PLEASE PRINT OR TYPE—INSTRUCTIONS ARE AVAILABLE ON THE BACK OF THIS FORM
1. LEGAL NAME OF DIRECT TRANSMITTER                                                                                     FOR CDTFA USE ONLY – CLIENT ID NUMBER

2. BUSINESS NAME (if different from above)

3. BUSINESS ADDRESS (street, city, state, ZIP Code)

4. MAILING ADDRESS (if different than above; street or P.O. Box, city, state, ZIP Code)

5. BUSINESS CONTACT INFORMATION (telephone, fax, and email address)

6. CONTACT REPRESENTATIVE

Name:                                                                                   Title: 
Email Address:                                                                          Telephone:
7. TYPE OF CERTIFICATION
                           I WANT TO BE CERTIFIED TO TRANSMIT RETURNS AS A: (check all that apply)

Tax Professional                                                                       Business Name: 
Software Developer                                                                     Name of Software Product: 
                                                                                       CDTFA Account Number: 
Taxpayer
                                                                                       Web Address: 
Electronic Return Originator                                                           Test Web Address (if available): 

8. APPLICATION AGREEMENT
Under penalty of perjury, I declare that I have examined this application and to the best of my knowledge the information I have 
provided is true, correct, and complete. I further declare that I am authorized to complete and sign this statement on behalf of 
the business. This business and its employees will comply with all the provisions of the California Department of Tax and Fee 
Administration’s publication 572, Direct Transmitter’s Guide, and related publications. I understand that if this business is sold or its 
organizational structure is changed, acceptance for participation is not transferable and a new/revised application must be filed. I  
further understand that noncompliance with all applicable provisions will result in termination of this agreement.
9. NAME AND TITLE OF THE REPRESENTATIVE COMPLETING THIS FORM (type or print)

10. SIGNATURE OF THE REPRESENTATIVE COMPLETING THIS FORM                                                                DATE

Please submit the completed application via email to eDirect@cdtfa.ca.gov, or mail to:
California Department of Tax and Fee Administration 
eServices Coordinator, MIC:40 
PO Box 942879 
Sacramento, CA 94279-0040

CDTFA-400-XML (BACK) REV. 3 (11-21)

                   INSTRUCTIONS FOR COMPLETING THE APPLICATION

To become a Direct Transmitter, you must submit your application and successfully complete testing prior to direct 
transmitting your first return or prepayment.
You may submit your email to eDirect@cdtfa.ca.gov, or mail to:
California Department of Tax and Fee Administration 
eServices Coordinator, MIC:40 
PO Box 942879 
Sacramento, CA 94279-0040
If you have any questions regarding this form or the Direct Transmit Program, please call 1-916-309-5399, Monday 
through Friday from 8:00 a.m. to 5:00 p.m. (Pacific time), or by email at eDirect@cdtfa.ca.gov.

                                               SPECIAL INSTRUCTIONS

Line 1 - Legal Name of Direct Transmitter: Enter the legal name of the business.

Line 2 - Business Name: Enter fictitious business name (DBA) if applicable.

Line 3 - Business Address: Enter the address of the physical location of your business.

Line 4 - Mailing Address: Enter the mailing address if different than the business address.

Line 5 - Business Contact Information: Enter the business telephone number, fax, and email address.

Line 6 - Contact Information: Enter the name, title, telephone number, and email address of the contact representative.

Line 7 - Type of Certification: If you are a tax professional (for example, accountant, CPA, bookkeeper, among others) 
and are not employed by the taxpayer, select Tax Professional and provide your name or the name of your business. 
If you are a software company developing software that clients will use to submit returns directly to CDTFA, select 
Software Developer and provide the name of the software product. If you are the taxpayer filing your own returns, select 
Taxpayer and provide your account number. If you are a company offering a web interface for clients to submit tax and 
fee information (no software provided), select Electronic Return Originator and provide your web address and a test web 
address (for testing purposes).

Line 8 - Application Agreement: Please read this section carefully prior to signing this application.

Lines 9 and 10 - Name, Title, Signature of the Representative Completing This Form, and Date: The individual 
authorized to complete and submit an application for the Direct Transmit Program must complete these lines.