Form Al8453-C - Corporation/partnership Income Tax Declaration For Electronic Filing - 2009

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FORM
A
D
R
LABAMA
EPARTMENT OF
EVENUE
AL8453-C
2009
I
& C
T
D
NDIVIDUAL
ORPORATE
AX
IVISION
Corporation/Partnership
Income Tax Declaration for Electronic Filing
For the tax period ______________________________, 20_______, through ______________________________, 20_______
NAME OF COMPANY
FEDERAL EMPLOYER IDENTIFICATION NUMBER
ADDRESS OF COMPANY
TELEPHONE NUMBER
PART I
Tax Return Information (Whole Dollars Only)
1 Alabama taxable income (Form 20C, line 14; Form 20C-C, line 1); or Non Separately
1
Stated Income Allocated and Apportioned to Alabama (Forms 20S/65, line 20) . . . . . . . . . . . . . . . . .
2
2 Total tax liability (Form 20C, line 15; Form 20C-C, line 2c; Form 20S, line 21) . . . . . . . . . . . . . . . . . . .
3 Total payments and credits (Form 20C, line 16h; Form 20C-C, line 3h;
3
Form 20S, line 22e) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Refund (negative number reported on Form 20C, line 18; Form 20C-C, line 5;
4
Form 20S, line 25) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 Amount you owe (positive number reported on Form 20C, line 18; Form 20C-C, line 5;
5
Form 20S, line 26) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
6 Amount of payment remitted electronically . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
PART II
Declaration of Officer/Partner (Sign only after Part I is completed.)
Under penalties of perjury, I declare that I am an officer/partner of the above company and that the information I have given my electronic return originator (ERO), transmitter, and/or inter-
mediate service provider (ISP) and the amounts in Part I above agree with the amounts on the corresponding lines of the company’s Alabama income tax return. To the best of my knowl-
edge and belief, the company’s return is true, correct, and complete. I consent to my ERO, transmitter, and/or ISP sending the company’s return, this declaration, and accompanying sched-
ules and statements to the Alabama Department of Revenue. I also consent to the Alabama Department of Revenue sending my ERO, transmitter, and/or ISP an acknowledgment of receipt
of transmission and an indication of whether or not the company’s return is accepted, and, if rejected, the reason(s) for the rejection. I have selected a personal identification number (PIN)
as my signature for the corporation/partnership’s electronic income tax return and, if applicable, the corporation/partnership’s consent to electronic funds withdrawal.
I authorize the Alabama Department of Revenue 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 corporation/partnership’s Alabama taxes owed on this return, and the financial institution to debit the entry to this account.
I authorize a representative of the Department of Revenue to discuss my return and attachments with my preparer.
Sign
Here
Signature of Officer/Partner
Date
Title
PART III
Declaration of Electronic Return Originator (ERO) and Paid Preparer (See Instructions)
I declare that I have reviewed the above company’s return and that the entries on Form AL8453-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 company’s 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 Alabama Department of Revenue, and have followed all other requirements in Pub. 3112, IRS e-file Application
and Participation, and Pub. 4163, Modernized e-File Information for Authorized IRS e-file Providers and Pub. AL4164 Software Developers and Transmitters Guidelines and Schemas for
Alabama Corporation and Partnership Income Tax Returns. If I am also the Paid Preparer, under penalties of perjury I declare that I have examined the above company’s return and accom-
panying 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.
Date
ERO’s SSN or PTIN
Check if also
Check if
ERO’s
ERO’s
paid preparer
self-employed
signature
Use
EIN
Firm’s name (or yours
Only
if self-employed),
address and ZIP code
Phone No. (
)
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct,
and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Date
Preparer’s SSN or PTIN
Check if
Preparer’s
Paid
self-employed
signature
Preparer’s
EIN
Firm’s name (or yours
Use Only
if self-employed),
address and ZIP code
Phone No. (
)
ERO Must Retain This Form
Do Not Submit This Form to the Alabama Department of Revenue Unless Requested To Do So

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