Arizona Form  
                                               Employer’s Withholding Tax Signature Authorization
            AZ-8879-W                                                                                                              2021

    Do not mail this form to the Arizona Department of Revenue.  The Employer must retain this document a minimum of four years.
Employer’s Name                                                                                          Employer Identification Number (EIN)

Employer’s Physical Address

City, Town                                                                     State                     ZIP Code

Purpose of form
• To declare, under penalties of perjury, that the electronic withholding tax return is, to the best of the employer’s knowledge and belief, true, correct, and 
 complete.
•To authorize the transmitter to transmit the employer’s confidential information to theArizona Department of Revenue and transmit acknowledgement,
 acceptance or rejection messages regarding the employer’s return to the employer.

PART 1 – WITHHOLDING TAX RETURN INFORMATION                                   PART 2 – FINANCIAL INSTITUTION INFORMATION
                                                                              Mustbepresentwhenrequestingdirectdebit.
    1Total liability .................................................... 1   TYPEOF ACCOUNT             ROUTINGNUMBER
    2Prior payments ...............................................       2    Checking    Savings
    3Amount due or refund ....................................            3   ACCOUNTNUMBER
Ifline3iszero,leavebox4,box5,line4andline5blank;otherwise                    
checkbox4orbox5:                                                              DIRECTDEBITREQUESTDATE     DIRECTDEBITPAYMENT AMOUNT
 4    AMOUNT DUE:  Enter the amount due ...                              4   M M    D D Y Y Y Y         $                         .00
   5  REFUND:  Enter the amount of refund ....                           5    Foreign Account:Seeinstructionsbelow.

 Box 4 – Amount Due:      You owe tax based on the information provided       Foreign Account Checkbox:  Check the “ForeignAccount” box if the
 on your withholding tax return. If you have elected to direct debit for      employer’s debit will ultimately come from a foreign account.  If you 
 payment, the payment will be withdrawn from the account on the date          check this box, do not enter the employer’s bank account information, 
 listedinPart2:FinancialInstitutionInformation                 .              we will not direct debit the account.  If the employer owes tax and is 
 Box 5 – Refund:     Youareduearefundbasedontheinformationprovided            required by pay by EFT, submit payment by ACH Credit to avoid 
 on your withholding tax return.  After the return is processed and payments  penalty.  If the employer owes tax and is NOT required to pay by 
 are confirmed, the overpayment will be applied to any outstanding            EFT, submit payment by ACH Credit or complete Form A1-WP, 
 liabilities, possibly in another tax type. If the overpayment exceeds the    mail it and a check to the Arizona Department of Revenue, PO Box 
 outstanding liabilities or the employer has no outstanding liabilities, a    29085, Phoenix, AZ  85038-9085.
 refund check will be issued and mailed to the employer. A refund will not 
 beissuedoncetheoverpaymentisappliedtoaliability.
PART 3 – DECLARATION AND SIGNATURE AUTHORIZATION (Sign only after completing Part I)
Underpenaltiesofperjury,IdeclarethatIhaveexaminedapapercopyofmyelectronicArizonawithholdingtaxreturnandaccompanyingschedulesand
statements for the period ending M M D D       Y Y Y Y , and to the best of my knowledge and belief, it is true, correct, and complete. I further declare 
thattheamountsofTotalLiability(Part1,line1),PriorPayments(Part1,line2),andAmountDueorRefund(Part1,line3andline4orline5)listedabove
are the amounts shown on the paper copy of my electronic Arizona withholding tax return.
IauthorizetheArizonaDepartmentofRevenue(DOR)anditsdesignatedfinancialagenttoinitiateanACHelectronicfundswithdrawal(directdebit)entry
to the financial institution account indicated in the tax preparation software for payment of my Arizona withholding taxes owed on this return. I also authorize 
thefinancialinstitutionsinvolvedintheprocessingoftheelectronicpaymentoftaxestoreceiveconfidentialinformationnecessarytoanswerinquiriesand
resolveissuesrelatedtothepayment.
IfIhave filed areturn with an amount due,Iunderstand thatiftheDORdoes notreceive full and timely paymentofmytaxliabilitybytheduedate,Iwill
remain liable for the tax liability and all applicable interest and penalties.
IconsenttosendingmyelectronicArizonawithholdingtaxreturnandaccompanyingschedulesandstatementstoDORthroughatransmitter.Iconsentto
DORsendingmytransmitteranacknowledgementofreceiptoftransmissionandanindicationofwhetherornotthetransmissionofmyreturnisaccepted
and,ifthereturnisrejected,thereason(s)fortherejection.Iftheprocessingofmyreturnorrefundisdelayed,IauthorizeDORtodisclosetomytransmitter
the reason(s) for the delay, or when the refund was mailed. If DOR contacts my transmitter for a copy of my return, any attachments or schedules to my
return,and/orthisauthorizationform,IauthorizemytransmittertoreleasecopiesoftherequesteddocumentstoDOR.

     Please 
     Sign 
     Here                                                                                                            (            )
                     EMPLOYER’SSIGNATURE                                                     DATE                    BUSINESSPHONENUMBER
ADOR11155(20)