California Tax

Taxpayer Name:  
Taxpayer ID Tax Department:
Taxpayer Verification:    
Tax Amount 1:
Tax Amount 2:
   Tax Amount 3:
 Total Amount Entered:
Zero Tax Due:  
    Receiving Bank ID: 122000496 Tax Period End Date:
Receiving Bank Account No.:    Tax Type Code:
                            Last Payment Date: Create Prenote:
                                    Hold Transfer: Prenote Date: