U.S. Fiduciary Income Tax Declaration and Signature OMB No. 1545-0967

for Electronic and Magnetic Media Filing Form 8453-F

Department of the Treasury

Internal Revenue Service

For calendar year 1992, or fiscal year beginning , 1992, and ending , 19

Name of estate or trust Employer identification number

Name and title of fiduciary

Tax Return Information

1 Total income (Form 1041, line 9) 1

2 Income distribution deduction (Form 1041, line 18) 2

3 Taxable income of fiduciary (Form 1041, line 22) 3

4 Total tax (Form 1041, line 23) 4

5 Tax due or overpayment (Form 1041, line 27 or 28) 5

Under penalties of perjury, I declare that the above amounts (or the amounts on the attached listing) agree with the amounts shown on the corresponding

lines of the 1992 U.S. Fiduciary Income Tax Return(s). I have also examined a copy of the return(s) being filed via electronic/magnetic media with the

Internal Revenue Service, and all accompanying schedules and statements. To the best of my knowledge and belief, they are true, correct, and complete.

If I am not the transmitter, I consent that the return(s), including this declaration and accompanying schedules and statements, be sent to the Internal

Revenue Service by the return transmitter. If the processing of the return(s) is delayed, I authorize the IRS to disclose to the paid preparer and/or the

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

Sign

Here

Signature of fiduciary or officer representing fiduciary Date

Cat. No. 13890F Form 8453-F (1992)

© ©

© See instructions on back.

Part III

Part I

Part II

I declare that I have reviewed the above fiduciary return(s) and that the entries on Form 8453-F are complete and correct to the best of my knowledge.

(EMMROs who are not paid preparers are not responsible for reviewing the fiduciary return(s); however, they must ensure that Form 8453-F accurately

reflects the data on the return(s).) I have obtained the fiduciary’s signature or the signature of the officer representing the fiduciary on Form 8453-F

before submitting the return(s) to the IRS, have provided the fiduciary or officer representing the fiduciary with a copy of all forms and information being

filed with the IRS, and have followed all other requirements described in Pub. 1437, Procedures for Electronic and Magnetic Media Filing of U.S. Fiduciary

Income Tax Return, Form 1041, for Tax Year 1992. If I am also the Paid Preparer, under penalties of perjury I declare that I have examined the above

fiduciary return(s) 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.

Date EMMRO’s social security number

EMMRO’s

Use Only

EMMRO’s

signature

Check if selfemployed ©

Firm’s name (or

yours if self-employed)

and address

E.I. No. ©

ZIP code ©

©

©

Declaration of Fiduciary

Date Preparer’s social security number

Paid

Preparer’s

Use Only Preparer’s

signature

Check if selfemployed ©

Firm’s name (or

yours if self-employed)

and address

E.I. No. ©

ZIP code ©

©

©

Check if 

also paid 

preparer ©

Under penalties of perjury, I declare that I have examined the above fiduciary return(s) 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.

Declaration of Electronic and/or Magnetic Media Return Originator (EMMRO) and Paid Preparer

(See instructions.)

For Paperwork Reduction Act Notice, see instructions.
Paperwork Reduction Act Notice

Who Must File

The time needed to complete and file this form will

vary depending on individual circumstances. The

estimated average time is: Recordkeeping, 7 minutes;

Learning about the law or the form, 4 minutes;

Preparing the form, 18 minutes; Copying,

assembling, and sending the form to the IRS, 20

minutes.

If you have comments concerning the accuracy of

these time estimates or suggestions for making this

form more simple, we would be happy to hear from

you. You can write to both the Internal Revenue

Service, Washington, DC 20224, Attention: IRS

Reports Clearance Officer, T:FP; and the Office of

Management and Budget, Paperwork Reduction

Project (1545-0967), Washington, DC 20503. DO NOT

send Form 8453-F to either of these offices. Instead,

see Where To File, below.

Where To File

When To File

Purpose of Form

Note: A tax return is not considered filed unless it is

signed. Form 8453-F is the signature document that

completes the filing of the Form(s) 1041 filed on

electronic or magnetic media.

Declaration of Electronic and/or Magnetic

Media Return Originator (EMMRO) and

Paid Preparer

A paid preparer who is not also the EMMRO must

sign Form 8453-F in the space for Paid Preparer’s

Use Only. A paid preparer who is also the EMMRO

should instead check the box in the EMMRO’s Use

Only section labeled “Check if also paid preparer.”

Form 8453-F (1992) Page 2

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.

Use Form 8453-F to (1) authenticate the electronic or

magnetic media Form 1041, U.S. Fiduciary Income Tax

Return; (2) serve as a transmittal for any

accompanying paper schedules, statements, and

magnetic media; and (3) authorize the electronic or

magnetic media filer to transmit via a third-party

transmitter.

Every estate or trust filing a 1992 Form 1041 via

electronic or magnetic media must file a signed Form

8453-F.

The signer must attach a multiple-return information

listing according to the instructions given in Pub. 1437,

Procedures for Electronic and Magnetic Media Filing of

U.S. Fiduciary Income Tax Return, Form 1041, for Tax

Year 1992. The information listing must include the

name control of each estate or trust, its employer

identification number (EIN), and the information shown

on lines 1 through 5 for each return.

Send Form 8453-F to: Internal Revenue Service,

Philadelphia Service Center, ATTN: Magnetic Media

Unit—DP 115, 11601 Roosevelt Blvd., Philadelphia, PA

19154.

An estate or trust must file its income tax return by the

15th day of the 4th month following the close of the

tax year of the estate or trust. This filing date also

applies to returns filed electronically or on magnetic

media. For returns filed electronically, the transmitter

must send the signed Form 8453-F the same day the

transmission is made. For returns filed on magnetic

tape or diskette, the transmitter must send the signed

Form 8453-F in the same package with the

corresponding tape or diskette.

The EMMRO is one who deals directly with the

fiduciary and either prepares tax returns or collects

prepared tax returns, including Forms 8453-F, for

fiduciaries who wish to have their returns electronically

or magnetically filed. The EMMRO’s signature is

required by the IRS.

Signature For Multiple-Return Filing

A single signature may be used for a multiple-return

filing if the fiduciary is authorized to sign each return.