Fillable Form Ms8453-C - Corporate Income Declaration

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Form 83-115-16-8-1-000 Rev. (05/16)

Mississippi

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Corporate Income Declaration for Electronic Filing

MS8453-C

2016

Tax Year Beginning

Tax Year Ending

DO NOT MAIL THIS DOCUMENT

FEIN

TO THE DEPARTMENT OF REVENUE

Legal Name and DBA

Address

City

State

Zip +4

County Code

PART I: TAX RETURN INFORMATION

(ROUND TO THE NEAREST DOLLAR)

1 Mississippi taxable income (Form 83-105, line 5 or Form 83-391, line 1)

2 Total income tax (Form 83-105, line 6 or Form 83-391, line 2)

3 Total payments & credits (Form 83-105, line 7 and line 12 or Form 83-391, line 3, 4 and 8)

4 Amount you owe (Form 83-105, line 18 or Form 83-391, line 14)

5 Overpayment (Form 83-105, line 19 or Form 83-391, line 15)

6 Refund (Form 83-105, line 21or Form 83-391, line 17)

7 Amount of payment remitted electronically

* If the corporation is filing a balance due return and the Department of Revenue does not receive full and timely payment of its tax liability,

the corporation will be liable for the tax liability and all applicable interest and penalties.

PART II: DECLARATION OF OFFICER

Under the penalties of perjury, I declare that I am an officer of the above corporation and that the information I have given my 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 lines of the corporation's Mississippi Corporate Income

& Franchise Tax Return. To the best of my knowledge and belief, the corporation's return is true, correct and complete. I consent to my ERO, transmitter, and/or ISP sending

the corporation's return, this declaration, and accompanying schedules and statements to the Department of Revenue (DOR). I also consent to the DOR my ERO, transmitter,

and/or ISP an acknowledgement of receipt of transmission and an indication of whether or not the corporation's return is accepted, and, if rejected, the reason(s) for the

rejection. This declaration is to be maintained by the ERO and provided to DOR on request.

Sign

Here

Signature of Officer

Date

Title

PART lll: DECLARATION OF ELECTRONIC RETURN ORIGINATOR (ERO) AND PAID PREPARER

I declare that I have reviewed the above corporation's return and that the entries on Form MS8453-C 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 corporate officer will have signed this form

before I submit the return. I will give the officer a copy of all forms and information to be filed with the Department of Revenue (DOR), and have followed all other requirements

in Pub. 3112, IRS e-file Application and Participation and Pub. 4163, Modernized e-File (MeF) Information for Authorized IRS e-file Providers. If I am also the Paid Preparer,

under penalties of perjury, I declare that I have examined the above corporation's return and accompanying schedules and statements, and to the best of my knowledge and

belief, they are true, correct and complete. This Paid Preparer declaration is based on all information of which I have any knowledge.

ERO

ERO Signature

Date

Check if Also

Check if Self-

ERO SSN or PTIN

Paid Preparer

Employed

Use

Only

Firm Name (or yours if

EIN

self-employed), address

and ZIP code

Phone No. (

)

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

Paid

Preparer Signature

Date

Preparer SSN or PTIN

Check if Also

Check if Self-

Preparer

Paid Preparer

Employed

Use Only

Firm Name (or yours if