Form 8879-S - Irs E-File Signature Authorization For Form 1120s - 2012
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2OMB No. 1545-1863
8879-S
IRS e-file Signature Authorization for Form 1120S
Form
2012
Do not send to the IRS. Keep for your records.
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Information about Form 8879-S and its instructions is at
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Department of the Treasury
Internal Revenue Service
For calendar year 2012, or tax year beginning
, 2012, ending
, 20
.
Name of corporation
Employer identification number
Part I
Tax Return Information (Whole dollars only)
1
1
Gross receipts or sales less returns and allowances (Form 1120S, line 1c)
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Gross profit (Form 1120S, line 3) .
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Ordinary business income (loss) (Form 1120S, line 21) .
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Net rental real estate income (loss) (Form 1120S, Schedule K, line 2)
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Income (loss) reconciliation (Form 1120S, Schedule K, line 18)
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Part II
Declaration and Signature Authorization of Officer (Be sure to get a copy of the corporation’s return)
Under penalties of perjury, I declare that I am an officer of the above corporation and that I have examined a copy of the corporation’s
2012 electronic income tax return and accompanying schedules and statements and to the best of my knowledge and belief, it is true,
correct, and complete. I further declare that the amounts in Part I above are the amounts shown on the copy of the corporation’s
electronic income tax return. I consent to allow my electronic return originator (ERO), transmitter, or intermediate service provider to
send the corporation’s return to the IRS and to receive from the IRS (a) an acknowledgement of receipt or reason for rejection of the
transmission, (b) the reason for any delay in processing the return or refund, and (c) the date of any refund. If applicable, 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. I have selected a personal identification number (PIN) as my signature for the corporation’s electronic
income tax return and, if applicable, the corporation’s consent to electronic funds withdrawal.
Officer’s PIN: check one box only
I authorize
to enter my PIN
as my signature
ERO firm name
do not enter all zeros
on the corporation's 2012 electronically filed income tax return.
As an officer of the corporation, I will enter my PIN as my signature on the corporation's 2012 electronically filed income tax
return.
Title
Officer’s signature
Date
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Part III
Certification and Authentication
ERO’s EFIN/PIN. Enter your six-digit EFIN followed by your five-digit self-selected PIN.
do not enter all zeros
I certify that the above numeric entry is my PIN, which is my signature on the 2012 electronically filed income tax return for the
corporation indicated above. I confirm that I am submitting this return in accordance with the requirements of Pub. 3112, IRS e-file
Application and Participation, and Pub. 4163, Modernized e-File (MeF) Information for Authorized IRS e-file Providers for Business
Returns.
ERO’s signature
Date
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ERO Must Retain This Form — See Instructions
Do Not Submit This Form to the IRS Unless Requested To Do So
8879-S
For Paperwork Reduction Act Notice, see instructions.
Form
(2012)
Cat. No. 37252K
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