ERO MUST RETAIN THIS FORM.
DO NOT SUBMIT THIS FORM TO
GEORGIA DEPARTMENT OF REVENUE
UNLESS REQUESTED TO DO SO.
IRS DCN OR SUBMISSION ID
GA-8453P
2016
GEORGIA PARTNERSHIP TAX RETURN DECLARATION FOR ELECTRONIC FILING
SUMMARY OF AGREEMENT BETWEEN TAXPAYER AND ERO OR PAID PREPARER
Beginning
20
, and Ending
20
Original Return
Amended Return
Final Return
Name Change
Change of Address
Composite Return
FEI Number
Name
Number of Partners
Resident
Non-Resident
GA Withholding Tax Acct. Number
Business Address
Country
Telephone Number
Payroll WH Number Nonresident WH Number
GA Sales Tax Reg. Number
City or Town
State
Zip Code
NAICS Code
Kind of Business
Location of Books for Audit (City & State)
TAX RETURN INFORMATION
PART I
1. Total Income for Georgia purposes (Schedule 1, Line 1) ..................................................
1.
2. Total Georgia net income (Schedule 1, Line 7) .................................................................
2.
DECLARATION OF PARTNER
PART II
Under the penalty of perjury, I declare that I am a general partner or limited liability company member of the above partnership and the information
I have provided to my Electronic Return Originator (ERO) and/or Online Service Provider and/or Transmitter, the amounts shown in Part I agree with
the amounts shown on the corresponding lines of the electronic portion of my 2016 Georgia Partnership Tax Return. I declare that I have examined
my tax return, including accompanying schedules and statements, and to the best of my knowledge and belief, my return is true, correct and
complete. I consent that the electronic portion of my return may be sent to the IRS by my ERO/Online Service Provider/Transmitter.
SIGN
HERE
Signature of Partner
Date
E-mail Address
DECLARATION OF ELECTRONIC RETURNS ORIGINATOR AND PAID PREPARER
PART III
I DECLARE THAT I HAVE REVIEWED THE ABOVE TAXPAYER'S RETURN AND THAT THE ENTRIES ON THE GA-8453P ARE COMPLETE
AND CORRECT TO THE BEST OF MY KNOWLEDGE.
ERO's Signature
Date
ERO'S
Firm's Name
Check also if paid preparer
USE
ONLY
Address
FEIN/PTIN
City, State & Zip Code
SSN/TIN
IF PREPARED BY A PERSON OTHER THAN THE TAXPAYER, THIS DECLARATION IS BASED ON ALL THE INFORMATION OF WHICH
THE TAXPAYER HAS KNOWLEDGE.
Paid Preparer's Signature
Date
PAID
PREPARER'S
Firm's Name
FEIN/PTIN
USE ONLY
Address
SSN/TIN
City, State & Zip Code
KEEP A COPY WITH YOUR RECORDS
GA-8453P (Rev. 09/26/16)
013