AUTHORIZATION AGREEMENT FOR PREAUTHORIZED PAYMENTS

TC 95-581 Rev. 12/07

COMPANY NAME

IFTA NUMBER

I (we) hereby authorize The Commonwealth of Kentucky, hereinafter called The Commonwealth, to initiate debits entries to my (our) checking account indicated below and the depository named below, hereinafter called DEPOSITORY, to debit the same to such account.

DEPOSITORY NAME	BRANCH
CITY	STATE ZIP
TRANSIT/ABA NO.	ACCOUNT NO.

This authority is to remain in full force and effect until The Commonwealth and DEPOSITORY has received written notification from me (or either of us) of it's termination in such time and in such manner as to afford The Commonwealth and DEPOSITORY a reasonable opportunity to act on it.

NAME	SELECT YOUR PASSWORD Must be 8 characters.
DATE   SIGNED  _______________________________________________
E-MAIL ADDRESS  PHONE NUMBER

MAIL TO:  Division of Motor Carriers  PO Box 2007 Frankfort, KY 40602
FAX TO: 502-696-1915 If faxing please include copy of voided check.

A voided check (or a copy of a voided check) is required with the completed form to authorize your filing of the Kentucky quarterly IFTA tax return using our website (http://transportation.ky.gov/dmc/). By using your IFTA number and password you can access the screen needed to electronically file the return. As you submit the return, the system will automatically print a copy of the return for your records to show that it was timely filed. The return also tells you the amount due and the earliest that funds will be transferred from your bank account to The Commonwealth's account.

The earliest money will be transferred will be two days after the due date of the return. For example, if you file your return on 10/20/08 and the due date is 10/31/08, the funds will not be transferred out of your account until 11/2/08.
A brief explanation of the ACH debit process may help explain this better. When you use a check to pay for something, the bank of the individual receiving your check uses the bank transit number and your account number (both of which are preprinted on the bottom of your check), to tell them which bank and account number your money is in so they can transfer it into their account. The ACH debit process allows us to keep these two numbers on file for you and process the transfer of the money when you have submitted your return electronically.

This process eliminates the need for you to fill out a paper tax return and mail it to us. It eliminates the need for us to process your return and prepare a deposit slip for our bank. Finally, it eliminates the need for either of our banks to process your check. Your bank statement will actually show that the amount deducted was transferred to The Commonwealth of Kentucky and was for your IFTA Tax return.
While you already provide us with this information four times a year when you send us your check, this information will be kept separate from your regular tax information in a secured location. Any changes to the password you selected or bank account number must be done in writing and will not be accessible through our normal call in procedures.