Business Information, items 1 to 3
EIN, business name and mailing address, with a line for an international province, country and postal code.
9779
Electronic Federal Tax Payment System - Business Enrollment
Form 9779 is the paper enrollment form a business uses to sign up for the Electronic Federal Tax Payment System (EFTPS), which the form's authorization describes as the system for paying federal taxes owed to the IRS electronically. It asks for the business's employer identification number (EIN), name and mailing address, a primary contact, the payment method, and the bank account details used when the business schedules payments itself.
The form says a sole proprietor business without employees enrolls as an individual instead, on Form 9783, EFTPS Individual Enrollment, using the primary Social Security Number. It also points to enrolling online at EFTPS.gov, which it says saves on mail time. The form says the information needed to use EFTPS arrives within seven business days after the enrollment form is received.
This page has the 12-2011 revision. You can fill out the PDF free in your browser on this page and download the result without an account.

EIN, business name and mailing address, with a line for an international province, country and postal code.
Primary contact name, a mailing address if different from item 3, and one phone number, U.S. or international.
Two choices: authorize a transaction yourself, which the form calls free, or have your financial institution initiate the transaction.
The EIN entered again, the nine-digit routing transit number, the account number, and whether the account is checking or savings.
Disclosure and debit authorization agreements and an authority to execute statement, followed by the printed name, signature and date.
The form says to use black or blue ink, print legibly and use only capital letters. For the name and address, it lists A-Z, 0-9, -, & and blank as the only valid characters.
Enter the EIN, then the business name and mailing address exactly as they appear on the tax return.
Name the primary contact. The form says an address entered in item 5 is used to mail confirmation materials. Give only one phone number.
Choose a payment method. The form says multiple accounts at one financial institution, or accounts at multiple institutions, each need a separate form.
The form says items 9 through 13 are completed when scheduling payments yourself and not through your financial institution. Enter the routing transit number, account number and account type.
Read the authorization agreements, then print the name, sign and date. The form says a form without a signature is returned.
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
The form says to mail it to EFTPS Enrollment Processing Center, P.O. Box 173788, Denver, CO 80217-3788.
The form says to visit EFTPS.gov to enroll online, 24 hours a day, 7 days a week, and that enrolling online saves on mail time.
The form says the information needed to use EFTPS arrives within seven business days after the enrollment form is received.
The form lists EFTPS Customer Service at 1-800-555-4477, En Español at 1-800-244-4829, and TDD (hearing impaired) support at 1-800-733-4829.
The Washington, DC address in the Privacy Act and Paperwork Reduction Notice is for comments on the time estimate. The form says not to send the enrollment form there.
Item 1 asks for the business's EIN, and items 2 and 3 for the name and mailing address exactly as they appear on the tax return.
The form says a sole proprietorship uses the owner's name rather than the DBA name. One without employees enrolls as an individual on Form 9783 instead.
A corporate officer, partner or fiduciary who signs for the taxpayer certifies authority to have payments made from the taxpayer's account.
A representative certifies authority to sign for the taxpayer, for example authority provided by Form 2848 or Form 8655.
Item 4 names the person, company or third party to contact if questions arise. The form says all EFTPS mailings are sent to the primary contact.
A business enrolls with this form and mails it to the EFTPS Enrollment Processing Center. The person who signs certifies authority to act for the taxpayer.
The agency’s own page for Form 9779.
The IRS instructions for filling out and filing Form 9779.
The official blank form, to print or fill by hand.
No tool matches that search.
The form says to visit EFTPS.gov to enroll online, and that enrolling online saves on mail time.
The form describes authorizing a transaction yourself as free. For transactions a financial institution initiates, it says to check with the institution first about availability and fees.
The form says a sole proprietor business without employees enrolls as an individual on Form 9783, EFTPS Individual Enrollment, using the primary Social Security Number.
The form says multiple accounts at one financial institution, or accounts at multiple institutions, need a separate form for each enrollment.
The form says a form without a signature is returned.
The form says the information needed to use EFTPS arrives within seven business days after the form is received.