Form Ga-8453 P - Georgia Partnership Tax Return Declaration For Electronic Filing, Summary Of Agreement - 2011

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KEEP WITH YOUR RECORDS
GA-8453 P
IRS DCN OR SUBMISSION ID
2011
GEORGIA PARTNERSHIP TAX RETURN DECLARATION FOR ELECTRONIC FILING
SUMMARY OF AGREEMENT BETWEEN TAXPAYER AND ERO OR PAID PREPARER
Beginning____________________20____, and Ending____________________20____
Original Return
Amended Return
Final Return
Change of Address
Composite Return
Name Change
Number of Partners
FEI Number
Name
Resident
Non-Resident
Ga. Withholding Tax Acct. Number
Business Address
Country
Telephone Number
Payroll WH Number Nonresident WH Number
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Business Code No. shown on Federal Return
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1. Total Income for Georgia purposes (Schedule 1, Line 1) ...................................................
1. _____________________________
2. Total Georgia net income (Schedule 1, Line 7) ...................................................................
2. _____________________________
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Under the penalty of perjury, I declare that I am a general partner or limited liability company member of the above partnership and the information
I have provided to my Electronic Return Originator (ERO) and/or Online Service Provider and/or transmitter, the amounts shown in Part I agree with
the amounts shown on the corresponding lines of the electronic portion of my 2011 Georgia Partnership Tax Return. I declare that I have examined
my tax return, including accompanying schedules and statements, and to the best of my knowledge and belief, my return is true, correct and complete.
I consent that the electronic portion of my return may be sent to the IRS by my ERO/Online Service Provider/transmitter.
S
IGN
H
ERE
Signature of Partner
Date
E-mail Address
P
III
DECLARATION OF ELECTRONIC RETURNS ORIGINATOR AND PAID PREPARER
ART
I DECLARE THAT I HAVE REVIEWED THE ABOVE TAXPAYER’S RETURN AND THAT THE ENTRIES ON THE GA-8453P ARE COMPLETE
AND CORRECT TO THE BEST OF MY KNOWLEDGE.
ERO’s Signature _____________________________________________________________
Date ______________________________
ERO’
S
Firm’s Name
_______________________________________________________________
Check if also paid preparer
U
SE
O
NLY
Address
_______________________________________________________________
FEIN/PTIN _________________________
_______________________________________________________________
SSN/TIN ___________________________
IF PREPARED BY A PERSON OTHER THAN THE TAXPAYER, THIS DECLARATION IS BASED ON ALL THE INFORMATION OF WHICH
THE TAXPAYER HAS KNOWLEDGE.
Paid Preparer’s Signature _____________________________________________________
Date ______________________________
P
AID
Firm’s Name
_______________________________________________________________
FEIN/PTIN _________________________
P
’
REPARER
S
U
O
SE
NLY
Address
_______________________________________________________________
SSN/TIN ___________________________
_______________________________________________________________
PLEASE DO NOT MAIL! KEEP WITH YOUR RECORDS
GA-8453P (Rev. 8/10)

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