U.S. Estate or Trust Income Tax Declaration and OMB No. 1545-0967

Signature for Electronic and Magnetic Media Filing Form 8453-F

Department of the Treasury

Internal Revenue Service

For calendar year 2001, or fiscal year beginning , 2001, and ending , 20

Name of estate or trust Employer identification number

Name and title of fiduciary

Tax Return Information

1 Total income (Form 1041, line 9) 1

2 Income distribution deduction (Form 1041, line 18) 2

3 Taxable income (Form 1041, line 22) 3

4 Total tax (Form 1041, line 23) 4

5 Tax due or overpayment (Form 1041, line 27 or 28) 5

Under penalties of perjury, I declare that the above amounts (or the amounts on the attached listing) agree with the amounts shown on the corresponding

lines of the electronic/magnetic media portion of the 2001 U.S. Income Tax Return(s) for Estates and Trusts. I have also examined a copy of the return(s)

being filed via electronic/magnetic media with the Internal Revenue Service, and all accompanying schedules and statements. To the best of my

knowledge and belief, they are true, correct, and complete. If I am not the transmitter, I consent that the return(s), including this declaration and

accompanying schedules and statements, be sent to the Internal Revenue Service by the return transmitter. I also consent to the IRS’ sending the

EMMRO and/or transmitter an acknowledgement of receipt of transmission and an indication of whether or not the return(s) is accepted, and, if rejected,

the reason(s) for the rejection. Sign

Here

Signature of fiduciary or officer representing fiduciary Date

Cat. No. 13890Y Form 8453-F (2001)

 

 See instructions on back.

Part III

Part I

Part II

I declare that I have reviewed the above estate or trust return(s) and that the entries on Form 8453-F are complete and correct to the best of my

knowledge. If I am only a collector, I am not responsible for reviewing the return(s), and only declare that this form accurately reflects the data on the

return(s). The fiduciary or an officer representing the fiduciary will have signed this form before I submit the return(s). I will give the fiduciary or officer

representing the fiduciary a copy of all forms and information to be filed with the IRS, and have followed all other requirements described in Pub. 1437,

Procedures for Electronic and Magnetic Media Filing of U.S. Income Tax Return for Estates and Trusts, Form 1041, for Tax Year 2001. If I am also the

Paid Preparer, under penalties of perjury I declare that I have examined the above estate or trust return(s) and accompanying schedules and statements,

and to the best of my knowledge and belief, they are true, correct, and complete. Declaration of preparer is based on all information of which the

preparer has any knowledge.

Date EMMRO’s SSN or PTIN

EMMRO’s

Use Only

EMMRO’s

signature

Check if selfemployed 

Firm’s name (or yours

if self-employed),

address, and ZIP code

EIN 

Phone no. ( )





Declaration of Fiduciary

Date Preparer’s SSN or PTIN

Paid

Preparer’s

Use Only Preparer’s

signature

Check if self-  employed 



Check if 

also paid 

preparer 

Under penalties of perjury, I declare that I have examined the above estate or trust return(s) and accompanying schedules and statements, and to the

best of my knowledge and belief, they are true, correct, and complete. Declaration of preparer is based on all information of which the preparer has

any knowledge.

Declaration of Electronic and/or Magnetic Media Return Originator (EMMRO) and Paid Preparer

See instructions.

For Paperwork Reduction Act Notice, see instructions.

Firm’s name (or yours

if self-employed),

address, and ZIP code Phone no. ( )

EIN 

2001
Paperwork Reduction Act Notice. We ask for the

information on this form to carry out the Internal

Revenue laws of the United States. You are required to

give us the information. We need it to ensure that you

are complying with these laws and to allow us to figure

and collect the right amount of tax.

Who Must File

The time needed to complete and file this form will

vary depending on individual circumstances. The

estimated average time is:

If you have comments concerning the accuracy of

these time estimates or suggestions for making this

form simpler, we would be happy to hear from you.

You can write to the Tax Forms Committee, Western

Area Distribution Center, Rancho Cordova, CA

95743-0001. Do not send Form 8453-F to this

address. Instead, see Where To File on this page.

IF you file

Form 8453-F by...

When To File

Purpose of Form

Caution: A tax return is not considered filed unless it is

signed. Form 8453-F is the signature document that

completes the filing of the Form(s) 1041 filed on

electronic or magnetic media.

Declaration of Electronic and/or Magnetic

Media Return Originator (EMMRO) and

Paid Preparer

A paid preparer who is not also the EMMRO must

sign Form 8453-F in the space for Paid Preparer’s

Use Only. A paid preparer who is also the EMMRO

should instead check the box in the EMMRO’s Use

Only section labeled “Check if also paid preparer.”

Form 8453-F (2001) Page 2

Use Form 8453-F to:

Every estate or trust filing a 2001 Form 1041 via

electronic or magnetic media must file a signed Form

8453-F.

Internal Revenue Service Center

ELF Processing Support Section—DP2720

P.O. Box 21028

Philadelphia, PA 19114.

An estate or trust must file its income tax return by the

15th day of the 4th month following the close of its tax

year. This filing date also applies to returns filed

electronically or on magnetic media. For returns filed

electronically, the transmitter must send the signed

Form 8453-F by the day the transmission is made. For

returns filed on magnetic tape or diskette, the

transmitter must send the signed Form 8453-F in the

same package with the corresponding tape or diskette.

The EMMRO is one who deals directly with the

fiduciary and either prepares tax returns or collects

prepared tax returns, including Forms 8453-F, for

fiduciaries who wish to have the return of the estate or

trust electronically or magnetically filed. The EMMRO’s

signature is required by the IRS.

Signature For Multiple-Return Filing

A single signature may be used for a multiple-return

filing if the fiduciary is authorized to sign each return.

The signer must attach a multiple-return information

listing according to the instructions in Pub. 1437,

Procedures for Electronic and Magnetic Media Filing of

U.S. Income Tax Return for Estates and Trusts, Form

1041, for Tax Year 2001. The information listing must

include the name control of each estate or trust, its

employer identification number (EIN), and the

information shown on lines 1 through 5 for each return.

Do not enter totals from multiple returns on lines 1

through 5.

Learning about the law or the form 5 min.

Recordkeeping 7 min.

Preparing the form 18 min.

Copying, assembling, and sending 

the form to the IRS 20 min.

You are not required to provide the information

requested on a form that is subject to the Paperwork

Reduction Act unless the form displays a valid OMB

control number. Books or records relating to a form or

its instructions must be retained as long as their

contents may become material in the administration of

any Internal Revenue law. Generally, tax returns and

return information are confidential, as required by

Internal Revenue Code section 6103.

Internal Revenue Service Center

ELF Processing Support Section—DP2720

11601 Roosevelt Blvd.

Philadelphia, PA 19154.

● Authenticate the electronic or magnetic media Form

1041, U.S. Income Tax Return for Estates and Trusts;

● Serve as a transmittal for any accompanying paper

schedules, statements, and magnetic media; and

● Authorize the electronic or magnetic media filer to

transmit via a third-party transmitter.

Then use this address...

U.S. mail

Private delivery service

Where To File