Form 8453-Ol - California Online E-File Return Authorization For Individuals

DO NOT MAIL THIS FORM TO FTB

Declaration Control Number (DCN)

Date Accepted

California Online e-file Return Authorization

TAXABLE YEAR

FORM

2006

for Individuals

8453-OL

Your first name and initial

Last name

Your SSN or ITIN

If joint return, spouse’s first name and initial

Last name

Spouse’s SSN or ITIN

Present home address — number and street, PO Box, rural route, or PMB no.

Apt. no.

Daytime telephone number

(

)

City, town or post office, state, and ZIP Code

Part I Tax Return Information (whole dollars only)

1 California adjusted gross income. Form 540, line 17; Form 540 2EZ, line 16; Long Form 540NR, line 21;

or Short Form 540NR, line 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

2 Refund or No Amount Due. (Form 540, line 69; Form 540 2EZ, line 26; Long Form 540NR, line 77;

or Short Form 540NR, line 77). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

3 Amount you owe. (Form 540, line 70; Form 540 2EZ, line 27; Long Form 540NR, line 78;

or Short Form 540NR, line 78). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

Part II Settle Your Account Electronically

4 m Direct Deposit of Refund

5 m Electronic Funds Withdrawal 5a Amount ___________________ 5b Withdrawal Date (MM/DD/YYYY) ______________

___

Part III Make Estimated Tax Payments for Taxable Year 2006

These are not installment payments for the current amount you owe.

First Payment

Second Payment

Third Payment

Fourth Payment

Due 4/16/07

Due 6/15/07

Due 9/17/07

Due 1/15/08

6 Amount

7 Withdrawal Date

Part IV Banking Information

(Have you verified your banking information? Incorrect information causes delays, which may cause penalties and interest.)

All or portion of total refund you want to directly deposit:

Remaining portion of total refund:

8 Routing number __________________________________

11 Routing number ____________________________________

9 Account number __________________________________

12 Account number ____________________________________

10 Type of account: m Checking

m Savings

13 Type of account: m Checking

m Savings

Part V Declaration of Taxpayer(s)

I authorize my account to be settled as designated in Part II. I further authorize my estimated tax payments to be withdrawn from a single account by

electronic funds withdrawal as designated in Part III. I understand that the banking information I provided in Part IV will be used to complete any transac-

tions designated in Part II or Part III. If I have filed a joint return, this is an irrevocable appointment of the other spouse as an agent to receive the refund

or authorize an electronic funds withdrawal.

Under penalties of perjury, I declare that the information I provided to the Franchise Tax Board (FTB), either directly or through e-file software, including

my name, address, and social security number (SSN) or individual taxpayer identification number (ITIN), the amounts shown in Part I above, and the

banking information shown in Parts II-IV above, agrees with the information and amounts shown on the corresponding lines of my 2006 California income

tax return. To the best of my knowledge and belief, my return is true, correct, and complete. If I am filing a balance due return, I understand that if the

FTB does not receive full and timely payment of my tax liability, I remain liable for the tax liability and all applicable interest and penalties. I authorize my

return and accompanying schedules and statements to be transmitted to the FTB directly or through the e-file software. If the processing of my return or

refund is delayed, I authorize the FTB to disclose to me, either directly or through the e-file software, the reason(s) for the delay or the date when

the refund was sent.



Sign

Here

Your signature

Date



Spouse’s signature. If filing jointly, both must sign.

Date

It is unlawful to forge a spouse’s signature.

FTB 8453-OL

(2006)