Form 8453-Llc - California E-File Return Authorization For Limited Liability Companies - 2010

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DO NOT MAIL THIS FORM TO FTB
_______________________
Date Accepted
California e-file Return Authorization for
FORM
TAXABLE YEAR
8453-LLC
2010
Limited Liability Companies
Limited liability company name
Identifying number
Part I Tax Return Information (whole dollars only)
1 Total income (Form 568, Schedule B, Line 12 or Form 568, Line 1 for Single Member LLCs) . . . . . . . . . . . . . . . . . .1__________________________
2 Ordinary income (Form 568, Schedule B, line 23 or Form 568, Line 1 for Single Member LLCs) . . . . . . . . . . . . . . . .2__________________________
3 Tax and fee due (Form 568, line 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3__________________________
4 Overpayment (Form 568, line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4__________________________
5 Total amount due (Form 568, line 16) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5__________________________
Part II Settle Your Account Electronically for Taxable Year 2010. (Due 04/15/11)
m
6
Electronic funds withdrawal
6a Amount ______________________
6b Withdrawal date (MM/DD/YYYY) ___________________
Part III Make Annual Tax or Estimated Fee Payment for Taxable Year 2011 This is NOT an installment payment for the current amount the LLC owes.
Annual Tax Payment
Estimated Fee Payment
7 Amount
8 Withdrawal date
Part IV Banking Information (Have you verified the LLC’s banking information?)
9 Routing number______________________________________________
10 Account number______________________________________________
11 Type of account: m Checking
m Savings
Part V Declaration of Officer
I authorize the limited liability company account be settled as designated in Parts II, III, and IV. If I check Box 6, I authorize an electronic funds withdrawal
for the amount listed on line 6a and for the 2011 annual tax or estimated fee payment amount listed on line 7 from the account specified in Part IV.
Under penalties of perjury, I declare that I am an officer of the above limited liability company and that the information I provided to my Electronic return
originator (ERO), Transmitter, or Intermediate Service Provider and the amounts in Part I above agree with the amounts on the corresponding lines of the
limited liability company’s 2010 California income tax return. To the best of my knowledge and belief, the limited liability company’s return is true, correct,
and complete. If the limited liability company is filing a balance due return, I understand that if the Franchise Tax Board (FTB) does not receive full and
timely payment of the limited liability company’s tax liability, the limited liability company will remain liable for the tax liability and all applicable interest and
penalties. I authorize the limited liability company return and accompanying schedules and statements be transmitted to the FTB by my ERO, transmitter,
or intermediate service provider. If the processing of the limited liability company’s return or refund is delayed, I authorize the FTB to disclose to my
ERO, intermediate service provider, the reason(s) for the delay or the date when the refund was sent.
Sign
Here
Signature of Officer
Date
Title
Part VI Declaration of Electronic Return Originator (ERO) and Paid Preparer. See instructions.
I declare that I have reviewed the above limited liability company’s return and that the entries on form FTB 8453-LLC are complete and correct to the best of
my knowledge. (If I am only an Intermediate Service Provider, I understand that I am not responsible for reviewing the limited liability company’s return. I
declare, however, that form FTB 8453-LLC accurately reflects the data on the return.) I have obtained the signature from the limited liability company officer
on form FTB 8453-LLC before transmitting this return to the FTB; I have provided the limited liability company officer with a copy of all forms and information
that I will file with the FTB, and I have followed all other requirements described in FTB Pub. 1345B, 2010 e-file Handbook for Authorized e-file Providers of
California Business Returns, and in FTB Pub. 1345, 2010 e-file Handbook for Authorized e-file Providers. I will keep form FTB 8453-LLC on file for four years
from the due date of the return or four years from the date the limited liability company return is filed, whichever is later, and I will make a copy available to
the FTB upon request. If I am also the paid preparer, under penalties of perjury, I declare that I have examined the above limited liability company’s return and
accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. I make this declaration based on
all information of which I have knowledge.
Date
Check if
Check
ERO’s SSN/PTIN
ERO’s-
ERO
also paid
if self-
signature
preparer
employed
Must
FEIN
Firm’s name (or yours
Sign
if self-employed)
ZIP Code
and address
Under penalties of perjury, I declare that I have examined the above limited liability company’s return and accompanying schedules and statements, and to
the best of my knowledge and belief, they are true, correct, and complete. I make this declaration based on all information of which I have knowledge.
Paid
Paid
Date
Check
Paid preparer’s SSN/PTIN
preparer’s
if self-
Preparer
signature
employed
Must
FEIN
Firm’s name (or yours
Sign
if self-employed)
ZIP Code
and address
FTB 8453-LLC 2010
For Privacy Notice, get form FTB 1131.

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