U.S. Corporation Income Tax Declaration OMB No. 1545-1866

for an IRS e-file Return Form 8453-C

Department of the Treasury

Internal Revenue Service For calendar year 2004, or tax year beginning , 2004, ending , 20

Name of corporation Employer identification number

Tax Return Information (Whole dollars only)

1 Total income (Form 1120, line 11) 1

2 Taxable income (Form 1120, line 30) 2

3 Total tax (Form 1120, line 31) 3

4 Tax due (Form 1120, line 34) 4

Sign

Here Signature of officer Title

Cat. No. 33331U Form 8453-C (2004)

 

File electronically with the corporation’s tax return. Do not file paper copies.

Part III

Part I

Part II

Date ERO’s SSN or PTIN

ERO’s

Use

Only

ERO’s

signature

Check if selfemployed

Firm’s name (or yours

if self-employed),

address, and ZIP code

EIN

Phone no. ( )





Declaration of Officer (see instructions) Be sure to keep a copy of the corporation’s tax return.

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 corporation’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.

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

For Privacy Act and Paperwork Reduction Act Notice, see page 2.

Firm’s name (or yours

if self-employed),

address, and ZIP code Phone no. ( )

EIN

5 Overpayment (Form 1120, line 35)

I consent that the corporation’s refund be directly deposited as designated on the Form 8050, Direct Deposit of

Corporate Tax Refund, that will be electronically transmitted with the corporation’s 2004 federal income tax return. 

I do not want direct deposit of the corporation’s refund or the corporation is not receiving a refund.

6a

I authorize the U.S. Treasury and its designated Financial Agent to initiate an electronic funds withdrawal (direct debit)

entry to the financial institution account indicated in the tax preparation software for payment of the corporation’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 the corporation is filing a balance due return, I understand that if the IRS does not receive full and timely payment of its tax

liability, the corporation will remain liable for the tax liability and all applicable interest and penalties.

b

c

Under penalties of perjury, I declare that I am an officer of the above corporation and that the information I have given my electronic return originator (ERO), transmitter,

and/or intermediate service provider (ISP) and the amounts in Part I above agree with the amounts on the corresponding lines of the corporation’s 2004 federal income

tax return. To the best of my knowledge and belief, the corporation’s return is true, correct, and complete. I consent to my ERO, transmitter, and/or ISP sending the

corporation’s return, this declaration, and accompanying schedules and statements to the IRS. I also consent to the IRS sending my ERO, transmitter, and/or ISP an

acknowledgment of receipt of transmission and an indication of whether or not the corporation’s return is accepted, any indication of a refund offset, and, if rejected,

the reason(s) for the rejection. If the processing of the corporation’s return or refund is delayed, I authorize the IRS to disclose to my ERO, transmitter, and/or ISP the

reason(s) for the delay, or when the refund was sent.

I declare that I have reviewed the above corporation’s return and that the entries on Form 8453-C 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 corporate 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.

3112, IRS e-file Application and Participation, and Pub. 4163, Modernized e-File Information for Authorized IRS e-file Providers of Forms 1120/1120S. If I am also the

Paid Preparer, under penalties of perjury I declare that I have examined the above corporation’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.

5

Date

2004
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

return preparers to provide their identifying numbers on the return.

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 Internal Revenue

Service, Tax Products Coordinating Committee,

SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, IR-6406,

Washington, DC 20224. Do not send Form 8453-C to this address.

Instead, see When and Where To File on this page.

When and Where To File

Purpose of Form

Part III. Declaration of Electronic Return

Originator (ERO) and Paid Preparer

Form 8453-C (2004) Page 2

Use Form 8453-C to:

File Form 8453-C with the corporation’s electronically filed

income tax 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.

Learning about the law or the form 28 min.

Recordkeeping 4 hrs., 46 min.

Preparing the form 1 hr., 30 min.

Copying, assembling, and sending 

the form to the IRS 16 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.

● Authenticate an electronic Form 1120, U.S. Corporation

Income Tax Return,

● Provide the corporation’s consent to directly deposit any

refund and/or authorize an electronic funds withdrawal for

payment of federal taxes owed.

If you are filing a 2004 Form 1120 through an ISP and/or

transmitter and you are not using an ERO, you must file

Form 8453-C with your electronically filed return. An ERO

can use either Form 8453-C or Form 8879-C to obtain

authorization to file a corporation’s Form 1120. Note: If the return is filed online through an ISP and/or

transmitter (not using an ERO), do not complete Part III.

Specific Instructions 

Name. Print or type the corporation’s name in the space

provided. 

Employer identification number (EIN). Be sure to enter the

corporation’s EIN in the space provided. 

Part II. Declaration of Officer 

Note: The corporate officer must check all applicable boxes

on line 6. 

If there is tax due (line 4) and the officer did not check box

6c, the corporation must use the Electronic Federal Tax

Payment System (EFTPS) or Form 8109, Federal Tax Deposit

Coupon, to pay its tax. The corporation must deposit the

payment no later than the 15th day of the 3rd month after

the end of its tax year. For EFTPS deposits to be made

timely, the corporation must initiate the transaction at least 1

business day before the date the deposit is due.

If the officer checks box 6c, 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. 

● Debit date (date the corporation wants the debit to occur). 

An electronically transmitted return will not be considered

complete, and therefore filed, unless either: 

● Form 8453-C is signed by a corporate officer, scanned into

a pdf file, and transmitted with the return or 

● The return is filed through an ERO and Form 8879-C 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

ERO, transmitter, and/or ISP:

The declaration of officer must be signed and dated by: 

● The president, vice president, treasurer, assistant treasurer,

chief accounting officer or 

● Any other corporate officer (such as tax officer) authorized

to sign the corporation’s income tax return.

General Instructions

Note: Instead of filing Form 8453-C, a corporate officer filing

a corporation’s return through an electronic return originator

(ERO) can sign the return using a personal identification

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

Signature Authorization for Form 1120.

● Authorize the ERO, if any, to transmit via a third-party

transmitter,

● Authorize the intermediate service provider (ISP) to

transmit via a third-party transmitter if you are filing online

(not using an ERO), and

● An acknowledgement that the IRS has accepted the

corporation’s electronically filed return,

● The reason(s) for any delay in processing the return or

refund, and

● If a refund offset may occur.

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.

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

requires the ERO’s signature. A paid preparer, if any, must

sign Form 8453-C in the space for Paid Preparer’s Use Only.

But if the paid preparer is also the ERO, do not complete the

paid preparer section. Instead, check the box labeled “Check

if also paid preparer.”

If the ERO makes changes to the electronic return after

Form 8453-C has been signed by the officer, whether it was

before it was transmitted or if the return was rejected after

transmission, the ERO must have the officer complete and

sign a corrected Form 8453-C if either:

● The total income on Form 1120, line 11, differs from the

amount on the electronic return by more than $150 or

● The taxable income on Form 1120, line 30, differs from the

amount on the electronic return by more than $100.