Form It-8879c - Declaration Of Electronic Filing - 2016
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1Do Not Mail This Form
Indiana S Corporation/Partnership Income Tax
Form
DECLARATION OF ELECTRONIC FILING
To The Indiana
IT-8879C
For calendar year 2016, or other tax year beginning
Department Of Revenue
State Form 55685
__________ , 2016 and ending __________ , ________
(R2/ 8-16)
Submission ID
Corporation/Partnership Name
Federal Identification Number
Street Address
City
State
ZIP Code
Daytime Telephone Number
Part I
Tax Return Information (See instructions on next page)
1. Total net income (loss) from U.S. S corporation/partnership return (IT-20S/IT-65, line 1)............
1.
2. Total S corporation/partnership income, as adjusted (IT-20S/IT-65, line 3)..................................
2.
3. IT-20S ONLY: Total income tax from Schedule B (IT-20S, line 12) ..............................................
3.
4. Total tax (IT-20S, line 15/IT-65, line 7)..........................................................................................
4.
5. Subtotal (IT-20S, line 22/IT-65, line 14) ........................................................................................
5.
6. Total amount due (IT-20S, line 26/IT-65, line 18) .........................................................................
6.
7. Refund (IT-20S, line 27/IT-65, line 19) .........................................................................................
7.
Part II
Declaration of Taxpayer
Under penalties of perjury, I declare that I am an officer of the S corporation/partnership listed above and the amounts in Part I agree with the
amounts on the corresponding lines of the electronic portion of the corporation’s/partnership’s 2016 Indiana income tax returns. To the best of my
knowledge and belief, this 2016 return is true, correct, and complete. I consent to my electronic return originator (ERO) sending my return, this
declaration, and accompanying schedule and statements to the Indiana Department of Revenue (department). I also consent to the department
sending my ERO and/or transmitter an acknowledgement of receipt of transmission and an indication of whether or not my return is accepted and,
if rejected, the reason(s) for the rejection. If the processing of my return or refund is delayed, I authorize the department to disclose to my ERO
and/or transmitter the reason(s) for the delay of when the refund was sent.
In addition, by using a computer system and software to prepare and transmit my return electronically, I consent to the disclosure to the department
of all information pertaining to my use of the system and software and to the transmission of my tax return electronically.
Officer’s signature ► _____________________________ Title ____________________ Date __________________________
Part III
Declaration of ERO/Preparer/Transmitter
I confirm that I am submitting this return in accordance with the IRS and Indiana Department of Revenue electronic filing programs.
ERO’s EFIN _____________________________ PTIN (if preparer) ________________________ Phone _______________________
ERO’s Signature ► ________________________
I
N
D
I
A
N
A
ERO Must Retain This Form - See instructions. Do Not Submit this form to DOR unless requested to do so.
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