S TATE OF   D  ELAWARE
                              DEPARTMENT OF       F INANCE
                               Division of Revenue
                                C arvel S tate B uilding
                               820 N ORTH F RENCH S TREET
                                     P.O. B ox 8763
                               WILMINGTON , DE  19898-8763

                                            SSN/TPID:  ______________________________
_______________________________________
Name

Dear Taxpayer:
We  are  providing  two  methods  of  payment  that  you  may  choose  from,  both  of  which
require ACH participation.
      METHOD #1: Payment of the full balance will take place within a period of 48
      months or less. The authorization for initiating this program is attached and
      must be completed and returned to us within 10 days. No legal action would be
      taken.
      METHOD #2: This method is long term and does require that legal action be
      taken. If a judgment has not been filed, we will take steps to secure that
      Judgment in the near future.  This procedure protects the financial interests
      of the State but in no way affects the installment arrangements you will be
      making.  Please be aware that the filing of a Judgment may have serious
      implications with respect to your credit ratings and will remain on your
      credit report for a period of 7 years after being satisfied.
During the time that you are in the installment program you must be sure to timely
file  your  taxes.    Your  account  is  subject  to  an  annual  review  of  financial
information.  All State, Federal and Maryland refunds will be offset and applied to
your account. If you believe your balance is paid before your scheduled end date, you
must notify The Division of Revenue.  No reimbursement will be given for bank charges
you may incur for overdrafts that occur before your set schedule end date

Please make your choice and sign below if you are in agreement with the above.
Enclosed are two (2) letters, you are required to return a signed letter within 30
business days and retain one copy for your records.

                                            Respectfully,

                                            _______________________________

TP# 1                                                     Date

TP# 2                                                     Date

cc: W100-B0/«User_Id»/«Case_Id»/«Folder_Id»

                                S TATE OF   D  ELAWARE
                              DEPARTMENT OF       F INANCE
                               Division of Revenue
                                C arvel S tate B uilding
                               820 N ORTH F RENCH S TREET
                                     P.O. B ox 8763
                               WILMINGTON , DE  19898-8763

                                            SSN/TPID:  ______________________________
_______________________________________
Name

Dear Taxpayer:
We  are  providing  two  methods  of  payment  that  you  may  choose  from,  both  of  which
require ACH participation.
      METHOD #1: Payment of the full balance will take place within a period of 48
      months or less. The authorization for initiating this program is attached and
      must be completed and returned to us within 10 days. No legal action would be
      taken.
      METHOD #2: This method is long term and does require that legal action be
      taken. If a judgment has not been filed, we will take steps to secure that
      Judgment in the near future.  This procedure protects the financial interests
      of the State but in no way affects the installment arrangements you will be
      making.  Please be aware that the filing of a Judgment may have serious
      implications with respect to your credit ratings and will remain on your
      credit report for a period of 7 years after being satisfied.
During the time that you are in the installment program you must be sure to timely
file  your  taxes.    Your  account  is  subject  to  an  annual  review  of  financial
information.  All State, Federal and Maryland refunds will be offset and applied to
your account. If you believe your balance is paid before your scheduled end date, you
must notify The Division of Revenue.  No reimbursement will be given for bank charges
you may incur for overdrafts that occur before your set schedule end date

Please make your choice and sign below if you are in agreement with the above.
Enclosed are two (2) letters, you are required to return a signed letter within 30
business days and retain one copy for your records.

                                            Respectfully,

                                            _______________________________

TP# 1                                                     Date

TP# 2                                                     Date

cc: W100-B0/«User_Id»/«Case_Id»/«Folder_Id»

                 AUTOMATIC PAYMENT PLAN

Dear Taxpayer:

The Division is now offering an automatic payment plan that saves you time and money.  No
more postage. No more worries about late or lost payments – all at no cost to you!

How Does It Work?
With the Automatic Payment Plan, your monthly installment is automatically deducted from your
checking or savings account each month.  When you receive your bank statement, it will show
the amount transferred from your account.  And your monthly billing statement will show that
payment applied to your installment.  It’s that easy.

How Do I Sign Up For Automatic Payment Plan?
To take advantage of the convenience of Automatic Payment Plan, simply complete the
authorization agreement form, attach a voided check or savings deposit slip, sign and return to
us at:

Delaware Division of Revenue
Attn: Installment Department
P.O. Box 830
Wilmington, Delaware  19899-0830 

Please continue to make your monthly payments as you normally do until you receive a letter
from us indicating when your Automatic Payment Plan will begin.

Sincerely
 
Attachment:  Automatic Payment Authorization Agreement

cc: W100-B0/«User_Id»/«Case_Id»/«Folder_Id»

            AUTOMATIC PAYMENT PLAN AUTHORIZATION AGREEMENT

Note – In order to process your request quickly and efficiently, you must include a voided check or savings
deposit slip with your completed authorization form.  Thank you.
 
1.  NAME OF YOUR BANK, SAVING AND LOAN OR CREDIT UNION                               2.  TRANSIT/ABA NO.

__________________________________________________________                           _______________________________________________________
3.  BRANCH                                                                           4.  DAYTIME PHONE NUMBER

_____________________________________________________________________________        __________________________________________________________________________

5.  SAVINGS OR CHECKING ACCOUNT NUMBER                                               6.  ACCOUNT NUMBER AS SHOWN ON DIVISION OF REVENUE
                                                                                     BILL
_____________________________________________________________________________
                                                                                     _______________________________________________________
__  CHECKING                                            __  SAVINGS

7.  YOUR NAME ON FINANCIAL INSTITUTION RECORDS                                       8.  YOUR ADDRESS AS IT APPEARS ON FINANCIAL INSTITUTION
                                                                                     RECORDS  
                                                                                     STREET_______________________________________________
_______________________________________________________________________________      CITY_____________________STATE_______ZIP_____________
                                                                                     ____________________________________________________________
                                                                                                                                                       
9.  SIGNATURE(S) AS SHOWN ON FINANCIAL INSTITUTION
  RECORDS
                                                                                     Official Use Only      
        Social Security Number                              Authorized Signature(s)
                                                                                     Taxpayer Identification No.  ___________________________
   __________________________       ________________________________________________
   __________________________      _________________________________________________ Revenue Code                     ___________________________                  
_______________________________________________________________________________

                                                                                     Tax Type                             ___________________________
10.  DATE _____________________________________________
                                                                                     Tax Period End                   ___________________________
I (WE) AUTHORIZE THE DELAWARE DIVISION OF REVENUE TO
INITIATE DEBIT ENTRIES TO MY (OUR) ACCOUNT INDICATED AND                             Amount                               ___________________________ 
THE BANK, SAVINGS AND LOAN OR CREDIT UNION, TO DEBIT THE
                                                                                     Payment Date
SAME TO SUCH ACCOUNT.                                                                                               ___________________________
THIS AUTHORIZATION TO REMAIN IN FULL FORCE AND EFFECT
UNTIL THE DELAWARE DIVISION OF REVENUE HAS RECEIVED
WRITTEN NOTIFICATION FROM ME (OR EITHER OF US) AS TO ITS
TERMINATION IN SUCH TIME AND IN SUCH MANNER AS TO AFFORD
THE DELAWARE DIVISION OF REVENUE AND THE FINANCIAL
INSTITUTION A REASONABLE OPPORTUNITY TO ACT UPON IT.

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Specific Instructions

Line 1
Enter the Financial institution from which funds will be transferred.

Line 2
Enter the Routing number.  The first two digits of the routing number must be 01 through 12 or 21 through 32.  Do
not use a deposit slip to verify the number.  (It may contain internal routing numbers that are not part of the
actual routing number.)

Line 3
Enter the Branch name of the Financial institution.

Line 4
Enter a daytime telephone number where you can be reached.

Line 5
Enter your bank account number.  The account number can be up to 17 characters (both numbers and letters).
Include hyphens but omit spaces and special symbols.  

Line 6
Enter the account number as shown on the Division of Revenue bill.

Line 7
Enter the name(s) in which the account is held.

Line 8
Enter the address as it appears on the financial institution records.

Line 9
Enter your social security number or your Federal Employers Identification number and your signature(s).
Reminder - if this is a joint account then both signatures are required.

Line 10
Enter today’s date.

Note – In order to process your request quickly and efficiently, you must include a voided check or savings
deposit slip with your completed authorization form.  Thank you.

cc: W100-B0/«User_Id»/«Case_Id»/«Folder_Id»

                                                              ATTENTION

HAVE YOU:

 INCLUDED A COPY OF YOUR VOIDED CHECK OR SAVINGS DEPOSIT SLIP?          Yes___   No___

CHOSEN THE DATE OF THE MONTH ON WHICH YOU WISH THE PAYMENT TO BE DEBITED TO YOUR
ACCOUNT?

                                                              TH       TH
THE DATE MUST BE BETWEEN THE 5  AND THE 26  OF EACH MONTH.

    Date Chosen

*PLEASE BE ADVISED:  TWO OR MORE INSUFFICIENT FUNDS TRANSACTIONS WILL RESULT IN A JUDGMENT
BEING FILED IN THE SUPERIOR COURT OF THE STATE OF DELAWARE, WITHDRAWAL OF THE PAYMENT
AGREEMENT, AND/OR LEGAL ACTION BEING TAKEN TO COLLECT THE FULL BALANCE DUE.

*MINIMUM PAYMENT REQUIRED IS $50.00.

THANK YOU FOR YOUR ASSISTANCE.

cc: W100-B0/«User_Id»/«Case_Id»/«Folder_Id»