Fillable Form 8879 - Irs E-File Signature Authorization

8879

OMB No. 1545-0074

IRS e-file Signature Authorization

Form

2016

Don’t send to the IRS. This isn’t a tax return.

▶

Keep this form for your records.

▶

Department of the Treasury

Internal Revenue Service

Information about Form 8879 and its instructions is at

▶

Submission Identification Number (SID)

Taxpayer’s name

Social security number

Spouse’s name

Spouse’s social security number

Part I

Tax Return Information — Tax Year Ending December 31, 2016 (Whole dollars only)

Adjusted gross income (Form 1040, line 38; Form 1040A, line 22; Form 1040EZ, line 4; Form 1040NR,

line 37) .

Total tax (Form 1040, line 63; Form 1040A, line 39; Form 1040EZ, line 12; Form 1040NR, line 61) .

Federal income tax withheld from Forms W-2 and 1099 (Form 1040, line 64; Form 1040A, line 40;

Form 1040EZ, line 7; Form 1040NR, line 62a) .

Refund (Form 1040, line 76a; Form 1040A, line 48a; Form 1040EZ, line 13a; Form 1040-SS, Part I, line 13a;

Form 1040NR, line 73a) .

Amount you owe (Form 1040, line 78; Form 1040A, line 50; Form 1040EZ, line 14; Form 1040NR, line 75)

Part II

Taxpayer Declaration and Signature Authorization (Be sure you get and keep a copy of your return)

Under penalties of perjury, I declare that I have examined a copy of my electronic individual income tax return and accompanying schedules and statements

for the tax year ending December 31, 2016, and to the best of my knowledge and belief, it is true, correct, and accurately lists all amounts and sources of income

I received during the tax year. I further declare that the amounts in Part I above are the amounts from my electronic income tax return. I consent to allow my

intermediate service provider, transmitter, or electronic return originator (ERO) to send my 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 ACH electronic funds withdrawal (direct debit) entry to the financial institution

account indicated in the tax preparation software for payment of my federal taxes owed on this return and/or a payment of estimated tax, and the financial

institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the

authorization. To revoke (cancel) a payment, I must contact the U.S. Treasury Financial Agent at 1-888-353-4537. Payment cancellation requests must be

received 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 further acknowledge that the

personal identification number (PIN) below is my signature for my electronic income tax return and, if applicable, my Electronic Funds Withdrawal Consent.

Taxpayer’s PIN: check one box only

✓

I authorize

to enter or generate my PIN

Pilot-Tax/Specialty Tax Services

ERO firm name

Enter five digits, but

don’t enter all zeros

as my signature on my tax year 2016 electronically filed income tax return.

I will enter my PIN as my signature on my tax year 2016 electronically filed income tax return. Check this box only if you are

entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III below.

Your signature

Date

▶

Spouse’s PIN: check one box only

✓

I authorize

Pilot-Tax/Specialty Tax Services

to enter or generate my PIN

ERO firm name

Enter five digits, but

don’t enter all zeros

as my signature on my tax year 2016 electronically filed income tax return.

I will enter my PIN as my signature on my tax year 2016 electronically filed income tax return. Check this box only if you are

entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III below.

Spouse’s signature

Date

▶

Practitioner PIN Method Returns Only—continue below

Part III

Certification and Authentication — Practitioner PIN Method Only

ERO’s EFIN/PIN. Enter your six-digit EFIN followed by your five-digit self-selected PIN.

Don’t enter all zeros

I certify that the above numeric entry is my PIN, which is my signature for the tax year 2016 electronically filed income tax return for

the taxpayer(s) indicated above. I confirm that I am submitting this return in accordance with the requirements of the Practitioner PIN

method and Pub. 1345, Handbook for Authorized IRS e-file Providers of Individual Income Tax Returns.

ERO’s signature

Date

▶

ERO Must Retain This Form — See Instructions

Don’t Submit This Form to the IRS Unless Requested To Do So

8879

For Paperwork Reduction Act Notice, see your tax return instructions.

Form

(2016)

Cat. No. 32778X

Form 8879 - Irs E-File Signature Authorization - 2016

Related Articles

Related forms

Related Categories