Form 8453-EMP

(October 2013)

Department of the Treasury 

Internal Revenue Service 

Employment Tax Declaration for an IRS e-file Return

For the period beginning , 20 , and ending , 20 . 

For use with Forms 940, 940-PR, 941, 941-PR, 941-SS, 943, 943-PR, 944, and 945. 

▶ File electronically. Do not file paper copies. 

▶ Information about Form 8453-EMP and its instructions is at www.irs.gov/form8453emp.

OMB No. 1545-0967

Name (as shown on Form 940, 940-PR, 941, 941-PR, 941-SS, 943, 943-PR, 944, or 945) Employer identification number 

Part I Type of Return and Return Information (Whole dollars only) 

Check the box for the return that you will file using this Form 8453-EMP. Enter the amounts from the applicable lines of the return. If 

any of the applicable lines on the return are blank, leave line 1b, 1c, 2b, 2c, 3b, 3c, 4b, 4c, 5b, or 5c, whichever is applicable, blank 

(do not enter -0-). However, if you entered -0- on the return, enter -0- on the applicable line. Complete a separate Form 8453-EMP for 

each return.

1a Form 940 check here ▶

(all 940 series) 

b. Total payments to all employees (Form 940, Part 2, line 3) 1b 

c. Balance due (Form 940, Part 4, line 14) . . . . . . . 1c 

2a Form 941 check here ▶

(all 941 series) 

b. Total taxes after adjustments (Form 941, Part 1, line 10) . 2b 

c. Balance due (Form 941, Part 1, line 12 (line 14 for the fourth

quarter of 2013)) . . . . . . . . . . . . . . . 2c 

3a Form 943 check here ▶

(all 943 series) 

b. Total wages subject to social security tax (Form 943, 

line 2) . . . . . . . . . . . . . . . . . . 3b 

c. Balance due (Form 943, line 15) . . . . . . . . . 3c 

4a Form 944 check here ▶ b. Wages, tips, and other compensation (Form 944, Part 1, 

line 1) . . . . . . . . . . . . . . . . . . 4b 

c. Balance due (Form 944, Part 1, line 11) . . . . . . . 4c 

5a Form 945 check here ▶ b. Total taxes (Form 945, line 3) . . . . . . . . . . 5b 

c. Balance due (Form 945, line 5) . . . . . . . . . . 5c 

Part II Declaration of Taxpayer (see instructions) 

6a I am requesting a refund on Form 940, 940-PR, 941, 941-PR, 941-SS, 943, 943-PR, 944, or 945.

b 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 federal taxes owed for the 

return indicated on lines 1a, 2a, 3a, 4a, or 5a, 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. 

Under penalties of perjury, I declare that I have an approved role (as identified in the instructions for the employment tax return) within the company listed above and the 

information I have given the 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 return. To the best of my knowledge and belief, the return is true, correct, and complete. I consent to the ERO, transmitter, and/or ISP sending the 

return, this declaration, and accompanying schedules and statements to the IRS. I also consent to the IRS sending the ERO, transmitter, and/or ISP an acknowledgment of 

receipt of transmission and an indication of whether or not the return is accepted and, if rejected, the reason(s) for the rejection. If the processing of the return or refund is 

delayed, I authorize the IRS to disclose to the ERO, transmitter, and/or ISP the reason(s) for the delay, or when the refund was sent. 

Sign 

Here 

▲

Taxpayer’s signature Print your name and title ▲Date ▲

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

I declare that I have reviewed the return indicated above and that the entries on Form 8453-EMP 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. 3112, IRS

e-file Application and Participation, Pub. 4163, Modernized e-File (MeF) Information for Authorized IRS e-file Providers for Business Returns, and Pub. 3823, Employment 

Tax e-file System Implementation and User Guide. If I am also the paid preparer, under penalties of perjury I declare that I have examined this return, including 

accompanying schedules and statements, and to the best of my knowledge and belief, it is 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 this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is 

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

Paid 

Preparer 

Use Only

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

Firm’s name ▶

Firm’s address ▶

Firm's EIN ▶

Phone no. 

For Privacy Act and Paperwork Reduction Act Notice, see instructions. Cat. No. 62873J Form 8453-EMP (10-2013) 
Form 8453-EMP (10-2013) Page 2 

Future Developments

For the latest information about developments related to Form 

8453-EMP and its instructions, such as legislation enacted after 

they were published, go to www.irs.gov/form8453emp.

General Instructions 

Note. Instead of filing Form 8453-EMP, a taxpayer filing an 

employment tax return through an electronic return originator (ERO) 

can sign the return using a personal identification number (PIN). 

For details, see Form 8879-EMP, IRS e-file Signature Authorization 

for Forms 940, 940-PR, 941, 941-PR, 941-SS, 943, 943-PR, 944, 

and 945.

Purpose of Form 

Use Form 8453-EMP to: 

• Authenticate an electronic Form 940, 940-PR, 941, 941-PR, 

941-SS, 943, 943-PR, 944, or 945; 

• 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 

• Provide the taxpayer’s consent to authorize an electronic funds 

withdrawal for payment of federal taxes owed. 

Who Must File 

If you are filing Form 940, 940-PR, 941, 941-PR, 941-SS, 943, 

943-PR, 944, or 945 through an ISP and/or transmitter and you are 

not using an ERO, you must file Form 8453-EMP with the 

electronically filed return. An ERO can use either Form 8453-EMP or 

Form 8879-EMP to obtain authorization to file Form 940, 940-PR, 

941, 941-PR, 941-SS, 943, 943-PR, 944, or 945.

When and Where To File 

File Form 8453-EMP with the taxpayer’s electronically filed return. 

Use a scanner to create a Portable Document Format (PDF) file of 

the completed form. Your tax preparation software will allow you to 

transmit this PDF with the return. 

Specific Instructions 

Name. Print or type the taxpayer’s name as shown on Form 940, 

940-PR, 941, 941-PR, 941-SS, 943, 943-PR, 944, or 945.

Employer identification number (EIN). Enter the EIN as shown on 

Form 940, 940-PR, 941, 941-PR, 941-SS, 943, 943-PR, 944, or 945.

Part II. Declaration of Taxpayer 

If the taxpayer has a balance due on line 1c, 2c, 3c, 4c, or 5c and 

the taxpayer did not check box 6b, the taxpayer must use the 

Electronic Federal Tax Payment System (EFTPS) to pay the tax. For 

more information on deposits, see the instructions for the tax form 

the taxpayer is filing. 

If the taxpayer checks box 6b, the taxpayer must ensure that the 

following information relating to the financial institution account is 

provided in the tax preparation software. 

• Routing number and account number. 

• Type of account (checking or savings). 

• Debit amount. 

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

An electronically transmitted return will not be considered 

complete, and therefore filed, unless either: 

• Form 8453-EMP is signed by the taxpayer, scanned into a PDF 

file, and transmitted with the return; or 

• The return is filed through an ERO and Form 8879-EMP is used to 

select a PIN that is used to electronically sign the return.

The taxpayer’s signature allows the IRS to disclose to the ERO, 

transmitter, and/or ISP: 

• An acknowledgement that the IRS has accepted the electronically 

filed return, and 

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

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 Part III. 

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

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

8453-EMP in the space for Paid Preparer 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.” 

Refunds. After the IRS has accepted the return, the refund should 

be issued within 3 weeks. However, some refunds may be delayed 

to ensure that returns are accurate. 

Use of PTIN

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

return must enter their preparer tax identification number (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 Form 8453-EMP 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 identifying numbers 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. Generally, tax returns and return information are confidential, 

as required by Internal Revenue Code section 6103. 

The time needed to complete and file this form will vary 

depending on individual circumstances. The estimated average time 

is: 

Recordkeeping . . . . . . . . . . . . 2 hr., 9 min. 

Learning about the law or the form . . . . . . . 6 min.

Preparing, copying, assembling, and sending 

the form to the IRS . . . . . . . . . . . . . 8 min. 

If you have comments concerning the accuracy of these time 

estimates or suggestions for making Form 8453-EMP simpler, we 

would be happy to hear from you. You can send us comments from 

www.irs.gov/formspubs. Click on More Information and then click 

on Comment on Tax Forms and Publications. Or you can send your 

comments to Internal Revenue Service, Tax Forms and Publications 

Division, 1111 Constitution Ave. NW, IR-6526, Washington, DC 

20224. Do not send Form 8453-EMP to this address. Instead, see 

When and Where To File on this page.