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Get CT TPG-138 2020-2024

Department of Revenue Services State of Connecticut 450 Columbus Blvd Ste 1 Hartford CT 06103-1837 TPG-138 Rev. 01/18 TPG-138 Application to Become a Third-Party Bulk Filer To register to become an approved Third-Party Bulk Filer TPBF provide the following information. Business name Federal Employer Identification Number FEIN Mailing address Connecticut Tax Registration Number if available City State Contact person Telephone number Email address Fax number ZIP code I will use TPBF to electronically transmit Income Taxes Business Taxes Individual Income Withholding Form CT-1040ES and Form CT-1040 EXT Form CT-8109 Form CT-945 Form CT-1096 Form 1099 Form CT-WH Form CT-941 Form CT-W3 and Form W-2 Trust and Estate Sales and Use Form OS-114 Corporation Business Attorney Occupational Form 472 Composite Income Admissions and Dues Form O-372 Form CT-1065/CT-1120SI and Form CT-1065/CT-1120SI EXT Business Entity Form OP-424 Payments Only Room Occupancy Form OP-210 By submitting this application the party named above agrees to comply with Connecticut laws and regulations in filing returns on the behalf of Connecticut taxpayers. This application in no way grants power of attorney for the party named above to act on behalf of Connecticut taxpayers in tax disputes. This application does not grant relationship would exist between the party named above and its client s. All returns must be timely filed and paid electronically on the Internet using the Connecticut Electronic Filing System* As a TPBF the party named above has the option to enter each client s filing information individually through the key and send method or to send an electronic file that contains the information for all its clients. Note One electronic payment cannot cover multiple accounts. Print your name sign and fax this application to DRS at 860-297-4761 or mail your request to Electronic Commerce Unit Print Name of Authorized Representative Title Signature of Authorized Representative Date After your application has been processed DRS will mail you a package containing a bulk filer identification number temporary password and additional information*. This application in no way grants power of attorney for the party named above to act on behalf of Connecticut taxpayers in tax disputes. This application does not grant relationship would exist between the party named above and its client s. This application does not grant relationship would exist between the party named above and its client s. All returns must be timely filed and paid electronically on the Internet using the Connecticut Electronic Filing System* As a TPBF the party named above has the option to enter each client s filing information individually through the key and send method or to send an electronic file that contains the information for all its clients. All returns must be timely filed and paid electronically on the Internet using the Connecticut Electronic Filing System* As a TPBF the party named above has the option to enter each client s filing information individually through the key and send method or to send an electronic file that contains the information for all its clients. Note One electronic payment cannot cover multiple accounts. Print your name sign and fax this application to DRS at 860-297-4761 or mail your request to Electronic Commerce Unit Print Name of Authorized Representative Title Signature of Authorized Representative Date After your application has been processed DRS will mail you a package containing a bulk filer identification number temporary password and additional information*.

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