Form 8453-EO

Department of the Treasury 

Internal Revenue Service 

Exempt Organization Declaration and Signature for 

Electronic Filing

For calendar year 2012, or tax year beginning , 2012, and ending , 20

For use with Forms 990, 990-EZ, 990-PF, 1120-POL, and 8868 

OMB No. 1545-1879

2012

Name of exempt organization Employer identification number

Part I Type of Return and Return Information (Whole Dollars Only)

Check the box for the type of return being filed with Form 8453-EO and enter the applicable amount, if any, from the return. If you 

check the box on line 1a, 2a, 3a, 4a, or 5a below and the amount on that line of the return being filed with this form was blank, then 

leave line 1b, 2b, 3b, 4b, or 5b, whichever is applicable, blank (do not enter -0-). If you entered -0- on the return, then enter -0- on the 

applicable line below. Do not complete more than one line in Part I.

1a Form 990 check here ▶ b Total revenue, if any (Form 990, Part VIII, column (A), line 12) . . 1b

2a Form 990-EZ check here ▶ b Total revenue, if any (Form 990-EZ, line 9) . . . . . . . 2b

3a Form 1120-POL check here ▶ b Total tax (Form 1120-POL, line 22). . . . . . . . . 3b

4a Form 990-PF check here ▶ b Tax based on investment income (Form 990-PF, Part VI, line 5) 4b

5a Form 8868 check here ▶ b Balance due (Form 8868, Part I, line 3c or Part II, line 8c) . . . 5b

Part II Declaration of Officer

6 I authorize the U.S. Treasury and its designated Financial Agent to initiate an Automated Clearing House (ACH) electronic funds 

withdrawal (direct debit) entry to the financial institution account indicated in the tax preparation software for payment of the 

organization’s federal taxes owed on this return, and the financial institution to debit the entry to this account. To revoke a payment, 

I must contact the U.S. Treasury Financial Agent at 1-888-353-4537 no later than 2 business days prior to the payment (settlement) 

date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential 

information necessary to answer inquiries and resolve issues related to the payment.

If a copy of this return is being filed with a state agency(ies) regulating charities as part of the IRS Fed/State program, I certify that I 

executed the electronic disclosure consent contained within this return allowing disclosure by the IRS of this Form 990/990-EZ/990-

PF (as specifically identified in Part I above) to the selected state agency(ies).

Under penalties of perjury, I declare that I am an officer of the above named organization and that I have examined a copy of the 

organization’s 2012 electronic return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, 

correct, and complete. I further declare that the amount in Part I above is the amount shown on the copy of the organization’s electronic 

return. I consent to allow my intermediate service provider, transmitter, or electronic return originator (ERO) to send the organization’s return 

to the IRS and to receive from the IRS (a) an acknowledgement of receipt or reason for rejection of the transmission, (b) the reason for any 

delay in processing the return or refund, and (c) the date of any refund.

Sign 

Here

▲

Signature of officer Date ▲

Title

Part III Declaration of Electronic Return Originator (ERO) and Paid Preparer (see instructions)

I declare that I have reviewed the above organization’s return and that the entries on Form 8453-EO 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 organization officer will have signed this form before I submit the return. I will give the officer a copy of all forms and 

information to be filed with the IRS, and have followed all other requirements in Pub. 4163, Modernized e-File (MeF) Information for Authorized 

IRS e-file Providers for Business Returns. If I am also the Paid Preparer, under penalties of perjury I declare that I have examined the above 

organization’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.

ERO’s 

Use 

Only

ERO’s 

signature ▲

Date Check if 

also paid 

preparer

Check if 

selfemployed

ERO’s SSN or PTIN

Firm’s name (or 

yours if self-employed), 

address, and ZIP code

▲

EIN

Phone no.

Under penalties of perjury, I declare that I have examined the above return 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.

Paid 

Preparer 

Use Only

Print/Type preparer’s name Preparer’s signature Date Check if 

self- employed 

PTIN

Firm’s name ▶

Firm’s address ▶

Firm's EIN ▶

Phone no. 

For Privacy Act and Paperwork Reduction Act Notice, see back of form. Cat. No. 36606Q Form 8453-EO (2012) 
Form 8453-EO (2012) Page 2 

TIP

Instead of filing Form 8453-EO, an organization officer filing an 

exempt organization’s return through an electronic return 

originator (ERO) can sign the return using a personal identification 

number (PIN). For details, see Form 8879-EO, IRS e-file Signature 

Authorization for an Exempt Organization.

IRS.gov

Should any unforeseen developments arise with respect to this form or its 

instructions after they are published, the IRS will create a page on IRS.gov at 

www.irs.gov/form8543eo to alert filers to the development and provide any 

necessary additional instructions.

Purpose of Form

Use Form 8453-EO to:

• Authenticate the electronic Form 990, Return of Organization Exempt From 

Income Tax; Form 990-EZ, Short Form Return of Organization Exempt From 

Income Tax; Form 990-PF, Return of Private Foundation; Form 1120-POL, 

U.S. Income Tax Return for Certain Political Organizations; or Form 8868, 

Application for Extension of Time To File an Exempt Organization Return;

• Authorize the ERO, if any, to transmit via a third-party transmitter;

• Authorize the intermediate service provider (ISP) to transmit via a thirdparty transmitter if you are filing online (not using an ERO); and

• Authorize an electronic funds withdrawal for payment of federal taxes owed 

(Form 990-PF, Form 1120-POL, or Form 8868 with payment).

Who Must File

If you are filing a 2012 Form 990, Form 990-EZ, Form 990-PF, Form 1120-

POL, or Form 8868 with payment through an ISP and/or transmitter and you 

are not using an ERO, you must file Form 8453-EO with your electronically 

filed return. An ERO can use either Form 8453-EO or Form 8879-EO to 

obtain authorization to file an organization’s Form 990, Form 990-EZ, Form 

990-PF, or Form 1120-POL, or to file a Form 8868 with payment.

When To File

Form 990, Form 990-EZ, and Form 990-PF. File Form 990, Form 990-EZ, or 

Form 990-PF by the 15th day of the 5th month after the organization’s accounting period ends. If the regular due date falls on a Saturday, Sunday, 

or legal holiday, the organization may file on the next business day. The Form

8453-EO must be filed with the electronically filed Form 990, Form 990-EZ, 

or Form 990-PF.

Form 1120-POL. File Form 1120-POL by the 15th day of the 3rd month after 

the organization’s accounting period ends. If the regular due date falls on a 

Saturday, Sunday, or legal holiday, the organization may file on the next 

business day. The Form 8453-EO must be filed with the electronically filed 

Form 1120-POL.

Form 8868. Generally, file Form 8868 by the due date of the return for which 

you are requesting an extension. The Form 8453-EO must be filed with the 

electronically filed Form 8868.

How To File

File Form 8453-EO with the organization’s electronically filed return. Use a 

scanner to create a PDF file of the completed form. Your tax preparation 

software will allow you to transmit this PDF file with the return.

Part II. Declaration of Officer

If a Form 990-PF, Form 1120-POL, or Form 8868 filer chooses to pay the tax 

due by electronic funds withdrawal (direct debit), check the box. Otherwise, 

leave the box blank.

If the officer checks the box when filing Form 990-PF, Form 1120-POL, or 

Form 8868 with payment, the officer must ensure that the following 

information relating to the financial institution account is provided in the tax 

preparation software.

• Routing number,

• Account number,

• Type of account (checking or savings),

• Debit amount, and

• Debit date (date the organization wants the debit to occur).

An electronically transmitted return will not be considered complete (and 

therefore not considered filed) unless either:

• Form 8453-EO is signed by an organization officer, scanned into a PDF file, 

and transmitted with the return, or

• The return is filed through an ERO and Form 8879-EO is used to select a 

PIN that is used to electronically sign the return.

The officer’s signature allows the IRS to disclose to the ISP, ERO, and/or 

transmitter:

• An acknowledgment that the IRS has accepted the organization’s 

electronically filed return, and

• The reason(s) for a delay in processing the return or refund.

The declaration of officer must be signed and dated by:

• The president, vice president, treasurer, assistant treasurer, chief 

accounting officer, or

• Any other organization officer authorized to sign the organization’s return.

If this return contains instructions to the IRS to provide a copy(ies) of the 

return to a state agency(ies) regulating charities as part of the IRS Fed/State 

program, the checkbox in Part II must be checked.

Part III. Declaration of Electronic Return Originator 

(ERO) and Paid Preparer

Note. If the return is filed online through an ISP and/or transmitter (not using 

an ERO), do not complete the ERO’s Use Only section in Part III.

If the organization’s return is filed through an ERO, the IRS requires the 

ERO’s signature. A paid preparer, if any, must sign Form 8453-EO in the 

space for Paid Preparer Use Only. 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.

An ERO may sign the Form 8453-EO by rubber stamp, mechanical device, 

or computer software program. The alternative method of signing must 

include either a facsimile of the individual ERO's signature or of the ERO's 

printed name.

Use of PTIN

Paid preparers. Anyone who is paid to prepare the organization's return 

must enter their PTIN in Part III. The PTIN entered must have been issued 

after September 27, 2010. For information on applying for and receiving a 

PTIN, see Form W-12, IRS Paid Preparer Tax Identification Number (PTIN) 

Application and Renewal, or visit www.irs.gov/ptin.

EROs who are not paid preparers. Only EROs who are not also the paid 

preparer of the return have the option to enter their PTIN or their social 

security number in the ERO's Use Only section of Part III. If the PTIN is 

entered, it must have been issued after September 27, 2010. For information 

on applying for and receiving a PTIN, see Form W-12, or visit 

www.irs.gov/ptin.

Privacy Act and 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. Section 6109 requires EROs to provide their 

identification number on the return.

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. The rules governing the 

confidentiality of the Form 990, Form 990-EZ, and Form 990-PF are covered 

in section 6104. Generally, tax returns (Form 1120-POL) and return 

information are confidential, as required by section 6103.

The time needed to complete and file this form will vary depending on 

individual circumstances. The estimated average time is:

Recordkeeping . . . . . . . . . . . . 4 hr., 32 min.

Learning about the law or the form . . . . . . . . . 18 min.

Preparing, copying, assembling, 

and sending the form to the IRS . . . . . . . . . 22 min.

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: 

Internal Revenue Service 

Tax Products Coordinating Committee 

SE:W:CAR:MP:T:M:S 

1111 Constitution Ave. NW, IR-6526 

Washington, DC 20224

Do not send Form 8453-EO to this address. Instead, see How To File on 

this page.