Declaration Control Number (DCN)

0 9 0 – – –

U.S. Individual Income Tax Declaration OMB No. 1545-0936 8453 for Electronic Filing Form

Department of the Treasury

Internal Revenue Service

For the year January 1–December 31, 1998

© See instructions on back.

Use the

IRS label.

Otherwise,

please

print or

type.

Telephone number (optional)

( )

Tax Return Information (Whole dollars only)

1 Total income (Form 1040, line 22; Form 1040A, line 14; Form 1040EZ, line 4) 1

2 Total tax (Form 1040, line 56; Form 1040A, line 34; Form 1040EZ, line 10) 2

3 Federal income tax withheld (Form 1040, line 57; Form 1040A, line 35; Form 1040EZ, line 7) 3

4 Refund (Form 1040, line 66a; Form 1040A, line 41a; Form 1040EZ, line 11a) 4

5 Amount you owe (Form 1040, line 68; Form 1040A, line 43; Form 1040EZ, line 12) 5 Attach Copy B of Forms W-2, W-2G, and 1099-R here.

Declaration of Taxpayer (Sign only after Part I is completed.)

Under penalties of perjury, I declare that the information I have given my ERO and the amounts in Part I above agree with the amounts on the

corresponding lines of the electronic portion of my 1998 Federal income tax return. To the best of my knowledge and belief, my return is true,

correct, and complete. I consent to my ERO sending my return, this declaration, and accompanying schedules and statements to the IRS. I also

consent to the IRS sending my ERO and/or transmitter an acknowledgment of receipt of transmission and an indication of whether or not my

return is accepted, and, if rejected, the reason(s) for the rejection. If the processing of my return or refund is delayed, I authorize the IRS to

disclose to my ERO and/or transmitter the reason(s) for the delay, or when the refund was sent.

Sign

Here © Your signature Date Spouse’s signature. If a joint return, BOTH must sign. Date

Declaration of Electronic Return Originator (ERO) and Paid Preparer (See instructions.)

I declare that I have reviewed the above taxpayer’s return and that the entries on Form 8453 are complete and correct to the best of my knowledge. If I am

only a collector, I am not responsible for reviewing the return and only declare that this form accurately reflects the data on the return. The taxpayer will

have signed this form before I submit the return. I will give the taxpayer a copy of all forms and information to be filed with the IRS, and have followed all

other requirements in Pub. 1345, Handbook for Electronic Return Originators of Individual Income Tax Returns. If I am also the Paid Preparer, under penalties

of perjury I declare that I have examined the above taxpayer’s return and accompanying schedules and statements, and to the best of my knowledge and

belief, they are true, correct, and complete. This Paid Preparer declaration is based on all information of which I have any knowledge.

Date Check Your social security number

if selfemployed

ERO’s

ERO’s signature

Use

Only

Firm’s name (or yours

if self-employed)

and address

EIN

ZIP code

Under penalties of perjury, I declare that I have examined the above taxpayer’s return and accompanying schedules and statements, and to the best of my

knowledge and belief, they are true, correct, and complete. This declaration is based on all information of which I have any knowledge.

Date Check Preparer’s social security no.

if selfemployed

Preparer’s Paid signature

Preparer’s

Use Only

Firm’s name (or yours

if self-employed)

and address ZIP code

Part II

Part I

©

©

©

©

© EIN

Cat. No. 62766T Form 8453 (1998)

If I have filed a balance due return, I understand that if the IRS does not receive full and timely payment of my tax liability, I will remain liable

for the tax liability and all applicable interest and penalties. If I have filed a joint Federal and state tax return and there is an error on my state

return, I understand my Federal return will be rejected.

IRS Use Only—Do not write or staple in this space.

I consent that my refund be directly deposited as designated in the electronic portion of my 1998 Federal income tax return. If I have filed

a joint return, this is an irrevocable appointment of the other spouse as an agent to receive the refund.

6a

I do not want direct deposit of my refund or I am not receiving a refund.

Check if

also paid

preparer

b

1998

Your first name and initial Last name Your social security number

L

A

B

E

L

H

E

R

E

If a joint return, spouse’s first name and initial Last name Spouse’s social security number

Home address (number and street). If you have a P.O. box, see instructions. Apt. no. IMPORTANT!

City, town or post office, state, and ZIP code.

You must enter

your SSN(s) above.

¶ ¶

Part III

I authorize (1) the U.S. Treasury and its designated Financial Agents to initiate an ACH debit (automatic withdrawal) entry to my

financial institution account designated in the electronic portion of my 1998 Federal income tax return for payment of my Federal

taxes owed, and (2) my financial institution to debit the entry to my account. I also authorize the financial institutions involved

in the processing of my electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve

issues related to my payment.

c

For Paperwork Reduction Act Notice, see back.
Form 8453 (1998) Page 2

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.

P.O. Box. Enter the box number only if the

post office does not deliver mail to the

taxpayer’s home.

Note: The address must match the address

shown on the electronically filed return.

The time needed to complete and file

this form will vary depending on individual

circumstances. The estimated average time

is 15 minutes. If you have comments

concerning the accuracy of this time

estimate 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 the form to this address.

Instead, see When and Where To File on

this page.

Part I—Tax Return Information

Part II—Declaration of Taxpayer

Line 5. Do not include the payment with

Form 8453. Instead, mail it by April 15,

1999, with Form 1040-V to the applicable

address shown on that form.

An electronically transmitted return will

not be considered complete, and therefore

filed, unless and until a Form 8453 signed

by the taxpayer is received by the IRS.

If the ERO makes changes to the

electronic return after Form 8453 has been

signed by the taxpayer but before it is

transmitted and either 1 or 2 below

applies, the ERO must have the taxpayer

complete and sign a corrected Form 8453.

1. The total income on line 1 differs from

the amount on the electronic return by

more than $25, or

2. The total tax on line 2, the refund on

line 4, or the amount owed on line 5 differs

from the amount on the electronic return

by more than $7.

Part III—Declaration of Electronic

Return Originator (ERO) and Paid

Preparer

Line Instructions

Declaration Control Number (DCN). The

DCN is a 14-digit number assigned by the

ERO to each return. Clearly type or print

the DCN in the top left corner of each

Form 8453. Enter the number after the IRS

has acknowledged receipt of the electronic

return as follows:

The IRS requires the ERO’s signature. A

paid preparer must sign Form 8453 in the

space for Paid Preparer’s Use Only. Only

handwritten signatures are acceptable. But

if the paid preparer is also the ERO, do not

complete the paid preparer’s section.

Instead, check the box labeled “Check if

also paid preparer.”

Boxes Entry

File identification number

(always “00”)

1–2

Refund Information. Refund information is

available on TeleTax. See the instruction

booklet for Form 1040, 1040A, or 1040EZ

for the phone number.

Electronic filer identification

number (EFIN) assigned by the

IRS

3–8

Batch number (000 to 999)

assigned by the ERO

9–11

Serial number (00 to 99)

assigned by the ERO

12–13

Year digit (for returns filed in

1999, the year digit is “9”)

14

Example. The EFIN is 509325. The

batch number is 000. The serial number is

56. The DCN is 00-509325-00056-9.

Name and Address. If the taxpayer

received a peel-off name and address label

from the IRS, place the label in the name

area. Cross out any errors and print the

correct information. Add any missing items,

When and Where To File

This form must be mailed to the service

center where the electronic return was

transmitted on the next working day after

the ERO has received acknowledgment

from the IRS that the return was accepted.

Only the Andover, Austin, Cincinnati,

Memphis, and Ogden Service Centers can

accept electronic returns. Get Pub. 1345,

Handbook for Electronic Return Originators

of Individual Income Tax Returns. It has

step-by-step mailing instructions and

addresses for the service centers.

Use Form 8453 to:

● Authenticate the electronic portion of

Form 1040, 1040A, or 1040EZ,

● Send any accompanying paper

schedules or statements,

● Authorize the electronic return originator

(ERO) to transmit via a third-party

transmitter, and

● Provide the taxpayer’s consent to

directly deposit any refund or authorize an

ACH debit (automatic withdrawal).

Purpose of Form

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.

Refunds. After the IRS has accepted the

return, the refund should be issued within

3 weeks. However, some refunds may be

delayed because of compliance reviews to

ensure that returns are accurate.

General Instructions

Note: If the paid preparer’s signature

cannot be obtained on Form 8453, you

may attach a copy of Form 1040, 1040A,

or 1040EZ instead. Attach only pages 1

and 2, and write “COPY—DO NOT

PROCESS” on each page.

Social Security Number (SSN). Be sure to

enter the taxpayer’s SSN in the space

provided on Form 8453. If a joint return,

list the SSNs in the same order as the first

names.

Note: All taxpayers must check the box on

line 6a, line 6b, or line 6c. If the taxpayer

checks the box on line 6c, the taxpayer

must ensure that the following information

relating to the financial institution account

is provided in the electronic portion of the

tax return:

● Routing number

● Account number

● Type of account (checking or savings)

● Debit amount

● Debit date (date the taxpayer wants the

debit to occur, but not later than April 15,

1999).

such as apartment number. If the taxpayer

did not receive a label, print or type the

information in the spaces provided.