Form 8453-Emp - Employment Tax Declaration For An Irs E-File Return

Download a blank fillable Form 8453-Emp - Employment Tax Declaration For An Irs E-File Return in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form 8453-Emp - Employment Tax Declaration For An Irs E-File Return with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

8453-EMP

Employment Tax Declaration for an IRS e-file Return

Form

For the period beginning

, 20

, and ending

, 20

OMB No. 1545-0967

(October 2013)

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

Department of the Treasury

File electronically. Do not file paper copies.

▶

Information about Form 8453-EMP and its instructions is at

Internal Revenue Service

▶

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

Employer identification number

Type of Return and Return Information (Whole dollars only)

Part I

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

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

▶

(all 940 series)

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

2a Form 941 check here

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

▶

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

(all 941 series)

quarter of 2013)) .

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

3a Form 943 check here

▶

line 2) .

(all 943 series)

c. Balance due (Form 943, line 15)

b. Wages, tips, and other compensation (Form 944, Part 1,

4a Form 944 check here

▶

line 1) .

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

5a Form 945 check here

b. Total taxes (Form 945, line 3) .

▶

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

Declaration of Taxpayer (see instructions)

Part II

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

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

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

Part III

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.

Date

Check if

Check if self-

ERO’s SSN or PTIN

ERO’s

also paid

employed

ERO’s

preparer

signature

Use

Firm’s name (or yours

EIN

Only

if self-employed),

address, and ZIP code

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.

Check if self-

Print/Type preparer’s name

Preparer’s signature

Date

PTIN

Paid

employed

Preparer

Firm’s name

Firm's EIN

Use Only