You can use this form to set up an automatic payment from your nominated bank account to Inland Revenue. The payments can be for a range of taxes including income tax, GST and FBT. You can also use this form to make additional payments on your student loan and to make child support payments.
PDF | 96kb | 2 pages
This form can be completed on-screen by typing content directly into the PDF document. Once you have completed the form it is important that you print it out as you will not be able to save the information you enter into the form.
Use this form to:
Give the completed and signed form to your bank.
By lodging this authority you are also accepting the conditions set out on page two of the form. Depending on the terms and conditions that apply to your nominated account, your financial institution may charge a fee. Government charges may also apply. If you have any questions please contact your financial institution.