Form Al8453-Fdt - Fiduciary Income Tax Declaration For Electronic Filing - 2013

FORM

A

D

R

LABAMA

EPARTMENT OF

EVENUE

AL8453-FDT

2013

I

& C

T

D

NDIVIDUAL

ORPORATE

AX

IVISION

Fiduciary

Income Tax Declaration for Electronic Filing

For the tax period ______________________________, 20_______, through ______________________________, 20_______

NAME OF ESTATE OR TRUST

FEDERAL EMPLOYER IDENTIFICATION NUMBER

NAME AND TITLE OF FIDUCIARY

TELEPHONE NUMBER

ADDRESS OF FIDUCIARY

PART I

Tax Return Information (Whole Dollars Only)

1

1 Alabama taxable income (Form 41, line 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2

2 Total tax liability (Form 41, line 6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3

3 Total credits (Form 41, line 8). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4

4 Total Reductions (Form 41, line 10d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5

5 Refund (negative number reported on Form 41, line 11). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6

6 Amount Due (positive number reported on Form 41, line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7

7 Amount of payment remitted electronically . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PART II

Declaration of Fiduciary/Officer (Sign only after Part I is completed.)

Under penalties of perjury, I declare that I am a fiduciary/officer of the above Estate/Trust and that the information I have given my electronic return originator (ERO), transmitter, and/or

intermediate service provider (ISP) and the amounts in Part I above agree with the amounts on the corresponding lines of the estate/trust’s Alabama Fiduciary income tax return. To the

best of my knowledge and belief, the estate/trust’s return is true, correct, and complete. I consent to my ERO, transmitter, and/or ISP sending the estate/trust’s return, this declaration, and

accompanying schedules 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 estate/trust’s return is accepted, and, if rejected, the reason(s) for the rejection. I have selected a per-

sonal identification number (PIN) as my signature for the estate/trust’s electronic Fiduciary income tax return and, if applicable, the estate/trust’s consent to electronic funds withdrawal.

I consent that the estate/trust’s tax refund as reported on the return, be directly deposited to the account indicated in the tax preparation software for tax year 2013.

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 estate/trust’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 Fiduciary/Officer

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-FDT 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 estate/trust’s fiduciary/officer will have signed this form before I sub-

mit the return. I will give the fiduciary/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. If I am also the Paid Preparer, under penalties of perjury I declare that I have examined the above estate/trust’s return and accompanying schedules and state-

ments, 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 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 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 for a period of three years from the due date of the return or the date the return was filed, whichever is later.

Do not submit this form to the Alabama Department of Revenue unless requested to do so.