Form 8453 

Department of the Treasury 

Internal Revenue Service 

U.S. Individual Income Tax Transmittal for an IRS e-file Return

For the year January 1–December 31, 2016

▶ See instructions on back.

▶ Information about Form 8453 and its instructions is available at www.irs.gov/form8453.

OMB No. 1545-0074

2016

Please 

print or 

type. 

P 

R 

I 

N 

T 

C 

L 

E 

A 

R 

L 

Y

Your first name and initial Last name Your social security number 

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

▲ Important! 

You must enter 

your SSN(s) above. 

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

City, town or post office, state, and ZIP code (If a foreign address, also complete spaces below.)

Foreign country name Foreign province/state/county Foreign postal code

FILE THIS FORM ONLY IF YOU ARE ATTACHING ONE OR MORE 

OF THE FOLLOWING FORMS OR SUPPORTING DOCUMENTS.

Check the applicable box(es) to identify the attachments.

Form 1098-C, Contributions of Motor Vehicles, Boats, and Airplanes (or equivalent contemporaneous written

acknowledgement)

Form 2848, Power of Attorney and Declaration of Representative (or POA that states the agent is granted authority to sign the

return)

Form 3115, Application for Change in Accounting Method

Form 3468 - attach a copy of the first page of NPS Form 10-168, Historic Preservation Certification Application (Part 2—

Description of Rehabilitation), with an indication that it was received by the Department of the Interior or the State Historic 

Preservation Officer, together with proof that the building is a certified historic structure (or that such status has been 

requested)

Form 4136 - attach the Certificate for Biodiesel and, if applicable, Statement of Biodiesel Reseller or a certificate from the

provider identifying the product as renewable diesel and, if applicable, a statement from the reseller

Form 5713, International Boycott Report

Form 8283, Noncash Charitable Contributions, Section A (if any statement or qualified appraisal is required), or Section B, 

Donated Property, and any related attachments (including any qualified appraisal or partnership Form 8283)

Form 8332, Release/Revocation of Release of Claim to Exemption for Child by Custodial Parent (or certain pages from a 

divorce decree or separation agreement, that went into effect after 1984 and before 2009) (see instructions)

Form 8858, Information Return of U.S. Persons With Respect to Foreign Disregarded Entities

Form 8864 - attach the Certificate for Biodiesel and, if applicable, Statement of Biodiesel Reseller or a certificate from the

provider identifying the product as renewable diesel and, if applicable, a statement from the reseller

Form 8885, Health Coverage Tax Credit, and all required attachments

Form 8949, Sales and Other Dispositions of Capital Assets (or a statement with the same information), if you elect not to 

report your transactions electronically on Form 8949

DO NOT SIGN THIS FORM.

For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 62766T Form 8453 (2016)
Form 8453 (2016) Page 2

General Instructions

What's New

Beginning in 2017, you will be able to electronically file 

Form 1040NR, U.S. Nonresident Alien Income Tax 

Return, and will be able to attach any related documents 

listed on page 1 to Form 8453.

Future Developments

For the latest information about developments related to 

Form 8453 and its instructions, such as legislation 

enacted after they were published, go to 

www.irs.gov/form8453.

Purpose of Form

Use Form 8453 to send any required paper forms or 

supporting documentation listed next to the checkboxes 

on Form 8453 (do not send Forms W-2, W-2G, or 

1099-R).

▲!

CAUTION

Do not attach any form or document that is not 

shown on Form 8453 next to the checkboxes. If 

you are required to mail in any documentation

not listed on Form 8453, you cannot file the tax

return electronically.

Note: Do not mail a copy of an electronically filed Form 

1040, 1040A, 1040EZ, 1040NR, or 1040-SS to the 

Internal Revenue Service (IRS).

When and Where To File

If you are an ERO, you must mail Form 8453 to the IRS 

within 3 business days after receiving acknowledgement 

that the IRS has accepted the electronically filed tax 

return.

If you are filing your tax return using an online provider, 

mail Form 8453 to the IRS within 3 business days after 

you have received acknowledgement from your 

intermediate service provider and/or transmitter that the 

IRS has accepted your electronically filed tax return. If 

you do not receive an acknowledgement, you must 

contact your intermediate service provider and/or 

transmitter.

Mail Form 8453 to:

Internal Revenue Service 

Attn: Shipping and Receiving, 0254 

Receipt and Control Branch 

Austin, TX 73344-0254

Line Instructions

Name and address. Print or type the information in the 

spaces provided. If using a foreign address, do not 

abbreviate the country name.

P.O. box. Enter the box number only if the post office 

does not deliver mail to the home address.

Note: The address must match the address shown on 

the electronically filed tax return.

Social security number (SSN). Be sure to enter the 

taxpayer’s SSN in the space provided on Form 8453. If a 

joint tax return, list the SSNs in the same order as the first 

names.

Payments

Do not attach a payment to Form 8453. Instead, mail it by 

April 18, 2017, with Form 1040-V to the IRS at the 

applicable address shown on that form. If a Form 1040-V 

is not available, see the instructions for your tax return for 

other ways to get forms or you can go to IRS.gov.

Form 2848. An electronically transmitted return signed by 

an agent must have a power of attorney attached to Form

8453 that specifically authorizes the agent to sign the 

return.

Divorce decree or separation agreement. If the divorce 

decree or separation agreement went into effect after 

1984 and before 2009, the noncustodial parent can 

attach certain pages from the decree or agreement

instead of Form 8332. To be able to do this, the decree or 

agreement must state all three of the following.

1. The noncustodial parent can claim the child as a 

dependent without regard to any condition (such as 

payment of support).

2. The other parent will not claim the child as a 

dependent.

3. The years for which the claim is released.

The noncustodial parent must attach all of the following 

pages from the decree or agreement.

• Cover page (include the other parent’s SSN on that 

page).

• The pages that include all of the information identified in 

(1) through (3) above.

• Signature page with the other parent’s signature and 

date of agreement.

Note: The noncustodial parent must attach the required 

information even if it was filed with a return in an earlier 

year.