U.S. S Corporation Income Tax Declaration OMB No. 1545-1867

for an IRS e-file Return

Form 8453-S

Department of the Treasury

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

Name of S Corporation Employer identification number

Tax Return Information (Whole dollars only)

1 Gross receipts or sales less returns and allowances (Form 1120S, line 1c) 1

2 Gross profit (Form 1120S, line 3) 2

4

Ordinary business income (loss) (Form 1120S, line 21)

4

Form 8453-S (2004)Cat. No. 64422I

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

5 Income (loss) reconciliation (Form 1120S, Schedule K, line 17e) 5

Part I

Part II

3 3

Net rental real estate income (loss) (Form 1120S, Schedule K, line 2)

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

Sign

Here  Signature of officer Date Title

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

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

Date Check ERO’s SSN or PTIN

if selfemployed

ERO’s ERO’s signature

Use

Only

Firm’s name (or

yours if self-employed),

address, and ZIP code

EIN

Phone no. ( )

Date Check Preparer’s SSN or PTIN

if selfemployed

Preparer’s Paid signature

Preparer’s

Use Only

Firm’s name (or

yours if self-employed),

address, and ZIP code Phone no. ( )









 EIN

Check if

also paid

preparer

Part III

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

6a 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.

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

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

Under penalties of perjury, I declare that I am an officer of the above named 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 S

corporation’s 2004 federal income tax return. To the best of my knowledge and belief, the S corporation’s return is true, correct and complete. I consent to

my ERO, transmitter, and/or ISP sending the S 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 acknowledgement of receipt of transmission and an indication of whether or not the S 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 S 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.

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.

2004
Form 8453-S (2004) Page 2

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 the form to this

address. Instead, see When and Where

To File on this page.

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.

The time needed to complete and file

this form will vary depending on

individual circumstances. The estimated

average time is:

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.

General Instructions

Purpose of Form

Who Must File

Use Form 8453-S to:

● Authenticate an electronic Form

1120S, U.S. Income Tax Return for an S

Corporation;

● Authorize the ERO, if any, to transmit

via a third-party transmitter;

When and Where To File

Recordkeeping 4 hr., 46 min.

Learning about the law or

the form 28 min.

Preparing the form 1 hr., 30 min.

Copying, assembling, and

sending the form to the IRS 16 min.

Specific Instructions

An electronically transmitted return will

not be considered complete, and

therefore filed, unless either:

● Routing number.

● Account number.

● Type of account (checking or savings).

● Debit amount.

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.

● Debit date (date the corporation wants

the debit to occur).

● Provide the corporation’s consent to

directly deposit any refund and/or

authorize an electronic funds withdrawal

for payment of Federal taxes owed.

Note: Instead of filing Form 8453-S, a

corporate officer filing a corporation’s

return through an ERO can sign the

return using a personal identification

number (PIN). For details, see Form

8879-S, IRS e-file Signature

Authorization for Form 1120S.

If you are filing a 2004 Form 1120S

through an ISP and/or transmitter and

you are not using an ERO, you must file

Form 8453-S with your electronically

filed return. An ERO can use either Form

8453-S or Form 8879-S to obtain

authorization to file the corporation’s

Form 1120S.

File Form 8453-S 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 your return.

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.

● Form 8453-S is signed by a corporate

officer, scanned into a pdf file, and

transmitted with the return or

The officer’s signature allows the IRS

to disclose to the ISP, ERO, and/or

transmitter:

The declaration of officer must be

signed and dated by:

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-S 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.”

● The return is filed through an ERO and

Form 8879-S is used to select a PIN that

is used to electronically sign the return.

● 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.

● 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.

Note: If the return is filed online through

an ISP and/or transmitter (not using an

ERO), do not complete Part III.

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.

Part II—Declaration of

Officer

Note: The corporate officer must check

all applicable boxes on line 6.

If the corporation has tax due and 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 tax

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 ERO makes changes to the

electronic return after Form 8453-S 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-S if

either:

● The total income (loss) on Form

1120S, line 6 differs from the amount on

the electronic return by more than $150

or

● The ordinary business income (loss)

on Form 1120S, line 21 differs from the

amount on the electronic return by more

than $100.

Part III—Declaration of

Electronic Return Originator

(ERO) and Paid Preparer