Thank you for submitting your Authorization to Process Tax Liabilities

Authorization Information

Officer Name: {{ $data['officer_name'] }}

Business Name: {{ $data['business_name'] }}

Sales Tax: {{ $data['sales_tax'] }}

Payroll Tax: {{ $data['payroll_tax'] }}

Corporation Tax: {{ $data['corporation_tax'] }}

Individual Tax: {{ $data['individual_tax'] }}

Contact Information

First Name: {{ $data['first_name'] }}

Last Name: {{ $data['last_name'] }}

Contact Address: {{ $data['contact_address'] }}

City/State/Zip: {{ $data['contact_city_state_zip'] }}

Phone: {{ $data['contact_phone'] }}

Fax: {{ $data['contact_fax'] }}

Email: {{ $data['contact_email'] }}

Company Information

Entity Name: {{ $data['entity_name'] }}

Entity Type: {{ $data['entity_type'] }}

State of Formation: {{ $data['state_formation'] }}

EIN Number: {{ $data['ein_number'] }}

Date of Formation: {{ $data['date_formation'] }}

Company Address: {{ $data['company_address'] }}

Suite: {{ $data['company_suite'] }}

Company City/State/Zip: {{ $data['company_city_state_zip'] }}

Bank Information

Account Title: {{ $data['account_title'] }}

Routing Number: {{ $data['routing_number'] }}

Account Number: {{ $data['account_number'] }}

Fee Amount: {{ $data['fee_amount'] }}

Officer Signature: {{ $data['officer_signature'] }}

Signature Date: {{ $data['signature_date'] }}

We have successfully received your filing and will process it soon.