Get Ta-w5206 Electronic Payment Authorization

Completing the Ta-w5206 Electronic Payment Authorization is an essential step for payees wanting to receive electronic payments under local highway and bridge programs in New York. This guide will provide you with clear, step-by-step instructions to ensure that your form is filled out correctly and submitted without issues.

Follow the steps to successfully complete the form

1. Click the ‘Get Form’ button to obtain the electronic Payment Authorization form and open it in your preferred editing tool.
2. In Part A, complete the fields beginning with your payee name. Ensure that your Federal Employer Identification Number is included, along with your complete address, phone number, and fax number if applicable.
3. Provide a contact name and email address for remittance notifications. Remember, only one account may be designated to receive electronic payments.
4. Select the type of account you wish to use for electronic deposits—either checking or savings. Fill in your account number and the routing number.
5. Next, enter the name and address of your financial institution. Your financial institution must complete Part B of this form.
6. In the authorization statement, read the declaration carefully and then provide the name and signature of the Chief Financial Officer or the equivalent, along with the date.
7. In Part B, have an authorized representative from your financial institution certify the provided information. They will need to print their name, title, signature, and contact number, as well as the date.
8. Once all sections are completed, save your changes. Download, print, or share the completed form as needed. Ensure that the form is mailed directly to the New York State Department of Transportation as specified on Page 1.

Start completing the Ta-w5206 Electronic Payment Authorization form online to ensure timely processing of your electronic payments.