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Form DP1 SF# 22917 (R5/ 1011)Indiana Department of RevenueApplication for Direct Payment Authorization A separate application is required for each business location. Federal Identification Number

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How to fill out application for direct payment

01

Obtain the application form for direct payment from the concerned authority.

02

Read the instructions carefully before filling out the form.

03

Start by providing your personal information such as name, address, contact details, etc.

04

Fill in the required financial details accurately, such as your bank account information.

05

Attach any necessary supporting documents, such as income statements or tax returns.

06

Double-check all the information entered and make sure it is correct.

07

Sign and date the application form.

08

Submit the completed application form along with the supporting documents to the appropriate authority.

09

Keep a copy of the application form and any receipts for future reference.

Who needs application for direct payment?

01

Anyone who is eligible for direct payment benefits or assistance programs may need to fill out an application for direct payment. This includes individuals or families who qualify for government subsidies, financial aid, unemployment benefits, social security benefits, or any other form of direct financial assistance provided by an organization or government agency.

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