Form Ia 8453-C - Corporation Income Tax Declaration For An E-File Return printable pdf download

2016 IA 8453-C

Iowa Corporation Income Tax Declaration for an e-File Return

https://tax.iowa.gov

For calendar year 2016 or tax year beginning

, 2016, ending

, 20

Name:

Federal Employer Identification Number (FEIN):

Part I Tax Return Information

Net Income after additions (IA 1120, line 4) .........................................................................................................1.

Income subject to tax (IA 1120, line 16) ...............................................................................................................2.

Total tax (IA 1120, line 19) ..................................................................................................................................3.

Total amount due (IA 1120, line 28).....................................................................................................................4.

Overpayment (IA 1120, line 29) ...........................................................................................................................5.

Part II Declaration of Officer (Be sure to keep a copy of the tax return)

I do not want direct deposit or direct debit.

I consent that the corporation’s refund be directly deposited as designated below.

I authorize the Iowa Department of Revenue (IDR) and its designated financial agent to initiate an electronic funds withdrawal (direct

debit) entry to the financial institution account indicated below for payment of the corporation’s Iowa taxes owed on this return, and the

financial institution to debit the entry to this account on ___________________________ (the

payment/settlement

date).

also

authorize the financial institution 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. This authorization is to remain in full force and effect until I

notify the IDR to terminate the authorization. To revoke (cancel) a payment, I must contact IDR at (515) 281-3114 or idreft@iowa.gov.

Payment cancellation requests must be received no later than 5 business days prior to the payment/settlement date. Note: This

electronic withdrawal from your bank account will be identified with ACH Company ID 4426004574. If you currently have a debit block

on this account, contact your financial institution to request that it allow a withdrawal from your bank account by this ACH Company ID.

Name of financial institution:

The first two digits must be 01 through 12, or 21 through 32.

Routing Number

Account Number

Type of Account:

Savings

Checking

Will this refund go to (or payment come from) an account outside the United States?

Yes

Under penalties of perjury, I declare that I am an officer of the above corporation and that I have examined the information on this electronic 2016 Iowa

corporation income tax return, including any schedules, attachments, and statements, and certify 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 that this return, including accompanying schedules, attachments, and statements be sent to Iowa Department of Revenue (IDR)

through the Internal Revenue Service (IRS) by the Electronic Return Originator (ERO). In addition, by using software to prepare and transmit this return

electronically, I consent to the disclosure to Iowa of all information pertaining to the transmission of this tax return electronically. I authorize IDR to inform

the ERO and/or transmitter when this electronic return has been accepted. In the event that it is rejected, I authorize IDR to identify the reasons for

rejection so that the return can be corrected and re-transmitted. If I have filed a balance due return, I understand that if IDR does not receive full and

timely payment of its tax liability, the corporation will remain liable for the tax liability and all applicable penalties and interest. I consent that the

corporation’s refund be directly deposited as designated in Part II and declare that the information shown in Part II is correct. If the processing of this

return, refund, or direct debit is delayed, I authorize IDR to disclose to the ERO and/or transmitter the reason(s) for the delay or the date the refund was

sent. I understand that this declaration with required attachments must be forwarded upon request to the IDR.

Officer’s Signature:

Date:

Title:

Part III Declaration of Electronic Return Originator (ERO) and Paid Preparer

I declare that I have reviewed the above corporation’s return and that entries on form IA 8453-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. I have

obtained the officer’s signature before submitting this return to the IRS. I have provided the officer with a copy of all forms and information to be filed with

IDR and have followed all other requirements described in the Iowa Modernized e-File (MeF) Information for e-File Providers publication. Original form

IA 8453-C should not be sent to IDR, but must instead be retained by the ERO for a period of three years from the date the return or the filing date,

whichever is later, to which the IA 8453-C relates was filed. I will make a copy available to IDR upon request. If I am a paid preparer, under penalties of

perjury, I declare that I have examined the above corporation’s return and accompanying schedules, attachments, and statements, and to the best of my

knowledge and belief, they are true, correct, and complete. I have based this declaration on all information available to me.

Check if

ERO

also paid

self-

Signature

Date

preparer

employed

ERO PTIN

Firm’s name (or yours