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INSTRUCTIONS FOR PA - 8 4 5 3

Line 3 - Enter the Total PA Tax Withheld from line

account ownership to their ERO. An acceptable

Filing of Form PA - 8 4 5 3

13, Form PA-40.

proof of account ownership is a check, form,

If a taxpayer elects not to use the Federal Self-

report, or other statement generated by the financial

Select PIN, or the return is filed without a Federal

Line 4 - Enter the Amount to be Refunded from

institution that has the taxpayer’s name, RTN of the

return, the PA Department of Revenue requires

line 29, Form PA-40.

financial institution, and the DAN preprinted on it.

Electronic Return Originators (EROs) and

For accounts that are payable through a financial

transmitters to retain completed Forms PA-

Line 5 - Enter the Total Payment (Tax Due), from

institution other than the one at which the account

8453 and supporting documents for three (3)

line 27, Form PA-40.

is located, the taxpayer must provide a document,

years after the due date of the return, or the

Taxpayers are responsible for submitting the pay-

such as an account statement or account identifi-

date the return was filed electronically,

ment due to the PA Department of Revenue by

cation card, showing the RTN of the bank or insti-

whichever date is later. EROs and transmitters

April 16, 2007. Taxpayers must use the preprinted

tution where the account is located. A deposit slip

must make the documents available to the PA

PA Individual Income Tax Payment Vo u c h e r,

should not be used to verify the RTN and DAN

Department of Revenue upon request. Do not

PA-V.

because it can contain internal routing numbers

mail Form PA-8453 and attachments to PA

that are not part of the RTN.

Department of Revenue unless requested.

In the event the taxpayer does not have a

preprinted voucher, the check or Money Order

If there is any doubt about the correct RTN, the

NOTE: If the ERO or transmitter closes their busi-

should be made payable to the PA Dept. of

taxpayer should contact the financial institution

ness, they must mail all of the forms to the follow-

Revenue. The last four digits of the taxpayer’s

and ask for the correct RTN for direct deposit or

ing address with a letter of explanation.

SSN, “2006 PA Tax” and daytime telephone num -

electronic funds withdrawal.

ber should be written on the payment.

PA Department of Revenue

NOTE: Some financial institutions may not accept

Bureau of Individual Taxes

PA Dept. of Revenue

direct deposits into accounts that are payable

Electronic Filing Section

Payment Enclosed

through another bank or financial institution,

PO Box 280507

1 Revenue Place

including credit unions.

Harrisburg, PA 17128-0507

Harrisburg, PA 17129-0001

Taxpayers filing electronically from home

P a r t I II - Declaration of Taxpayer

computers must keep the signed Form PA-

P a r t I I - Direct Deposit of Refund

8453 and supporting documents for three (3)

Line 10 - All filers must check one of the boxes.

or Electronic Funds Withdrawal

years after the due date of the return, or the

date the return was filed electronically,

Taxpayers can elect to have their refund directly

NOTE: Taxpayers can revoke the electronic funds

whichever date is later. Taxpayers must make

deposited or elect the electronic funds withdrawal

withdrawal authorization by notifying the

the documents available to the PA Department of

method of payment by completing Part II.

PA Department of Revenue in writing no later

Revenue upon request. Do not mail Form PA-

than two business days prior to the debit date.

Line 6 - The routing transit number (RTN) must

8453 and attachments to the PA Department of

Written requests to revoke the electronic funds

contain nine digits. If the RTN does not begin

Revenue unless requested.

withdrawal must include the taxpayer’s name,

with 01 through 12, or 21 through 32, the direct

address, social security number, routing transit

deposit or electronic funds withdrawal request

number (RTN), depositor account number (DAN)

will be rejected.

Line Instructions – Form PA - 8 4 5 3

and payment amount. Written requests can

be faxed to (717) 705-6651 or e-mailed to

Declaration Control Number (DCN) - The DCN

Line 7 - The depositor account number (DAN)

ra-achrevok@state.pa.us.

can contain up to 17 alphanumeric characters.

is a 14-digit number assigned by the Electronic

Include hyphens, but omit spaces and special

Return Originator (ERO) to each taxpayer’s

After the return has been prepared and

symbols. If fewer than 17 characters, enter the

return. For the PA Tax Return it will be the same

before the return is transmitted, the taxpayer

number from left to right and leave the unused

number as on the federal return.

(and spouse, if joint) must verify the informa-

boxes blank.

tion on the return and sign and date the com-

Name, Address, and Social Security Number -

pleted Form PA-8453. The ERO must provide

Line 8 - Check the appropriate box.

Print or type the taxpayer’s name (last name first)

the taxpayer with a copy of this form.

and complete address including zip code. In the

Line 9 - Debit Date - Enter the date that the taxpayer

spaces provided, you must enter the taxpayer’s

If the ERO makes changes to the electronic return

wants the payment electronically withdrawn, but

correct Social Security Number and that of the

after the Form PA-8453 has been signed by the

no later than April 16, 2007, if filed on or before

spouse, if applicable. If a husband and wife use

taxpayer, but before it is transmitted, the ERO

April 16, 2007.

must have the taxpayer complete and sign a cor-

different last names, please separate the names

rected Form PA-8453.

as in the following example: Paul A. Smith and

CAUTION: The account cannot include the name

Joan A. Weston would be Smith, Paul A. and Joan

of any other person unless the taxpayer’s filing

A. Weston.

status on the return is married filing joint or mar -

P a r t I V - Declaration of Electronic

The address must match the address shown

ried filing separately, and the taxpayer’s spouse is

R e t u rn Originator (ERO) and Preparer

on the electronically filed PA-40.

the other name listed on the account.

The PA Department of Revenue requires the

ERO to sign this form and keep it along with

Some financial institutions do not permit the

the required attachments for three years.

P a rt I - Tax Return Inform a t i o n

deposit of a joint refund in an individual account.

The PA Department of Revenue is not responsible

Line 1 - Enter the Adjusted PA Taxable Income

A preparer must sign the Form PA-8453 in the

when a financial institution refuses a direct

from line 11, Form PA-40.

space for Preparer. If the Preparer is also the

deposit for this reason.

ERO, do not complete the Preparer Section;

Line 2 - Enter the PA Tax Liability from line 12,

To be eligible for direct deposit or electronic funds

instead check the box labeled “Check if also

Form PA-40.

withdrawal, taxpayers must provide proof of

paid preparer. ”

Form Pa - 8453 - Pennsylvania Individual Income Tax Declaration For Electronic Filing - 2006 Page 2

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