Form 8879-Vt-F - Vermont Fiduciary Income Tax Declaration For Electronic Filing

VERMONT

VT Form

For office use only

8879-VT-F

Fiduciary Income Tax Declaration for Electronic Filing

Date received

(SEE INSTRUCTIONS IN THE VT FED/STATE E-FILE HANDBOOK)

Part I

Name of Estate or Trust

Federal ID Number

Address

Fiscal Year END Date (YYYYMMDD)

City

State

ZIP Code

Telephone Number

(

)

Foreign Country

E-mail Address

Part II Tax Return Information (whole dollars only)

1. Refund credited to next year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. ________________________

2. Refund amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. ________________________

3. Amount due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. ________________________

DO NOT MAIL THIS FORM

è

ç

-- KEEP THIS FORM AND REQUIRED ATTACHMENTS ON FILE FOR 3 YEARS

Part III

c Direct Deposit of Refund

c ACH Debit Payment Amount $____________ Payment Date ____/____/____

Routing transit number (RTN)

The first two numbers of the RTN must be 01 through 12 or 21 through 32.

Depositor account number (DAN)

Type of account:

c Savings

c Checking

Part IV Declaration of Taxpayer

By signing below, you agree that:

•

Under penalties of perjury, I declare the information I provided to my Electronic Return Originator (ERO) and the amounts shown in Part II agree

with the amounts shown on the corresponding lines of my Vermont Fiduciary Income tax return noted above, and is, to the best of my knowledge

and belief, true, accurate and complete.

•

If making an ACH Debit Payment, I authorize the Department to withdraw funds from my account in the amount and on the date specified.

•

I consent to have the ERO forward my return, including this declaration and accompanying schedules and statements, to the Vermont Department

of Taxes upon the Department’s request.

•

If the Vermont Department of Taxes does not receive full and timely payment of the amount due, I am liable for the tax and any applicable charges.



Please Sign

Here

Your Signature

Date

Printed Name

Title

Part V Declaration of Electronic Return Originator (ERO) Only

As an ERO, I am not responsible for review of the taxpayer’s return but declare this form accurately reflects the data on the return. The taxpayer(s)

signed this form before I submitted the return. I will give the taxpayer a copy of all forms and information to be filed with Vermont.



ERO’s

Electronic

Date

Check if:

paid preparer

c

signature

self-employed

c

Return

EIN

Originator’s

Firm’s name



(or yours if

Use Only

Phone Number

self-employed)

and address

E-mail address:

Part VI Declaration of Paid Preparer

Under penalties of perjury, I declare that I have examined the above taxpayer’s return and accompanying schedules and statement. 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 knowledge.



Date

Check if

Preparer’s

self-employed

Paid

signature

Preparer’s

EIN

Firm’s name



Use Only

(or yours if

Phone Number

self-employed)

and address

E-mail address:

Form 8879-VT-F

10/15