IRS e-file Signature Authorization
OMB No. 1545-1878
for an Exempt Organization
For calendar year 2015, or fiscal year beginning
, 2015, and ending
| Do not send to the IRS. Keep for your records.
Department of the Treasury
| Information about Form 8879-EO and its instructions is at
Internal Revenue Service
Name of exempt organization
Employer identification number
CANCER SUPPORT COMMUNITY MONTANA
Name and title of officer
Type of Return and Return Information
(Whole Dollars Only)
Check the box for the return for which you are using this Form 8879-EO and enter the applicable amount, if any, from the return. If you check the box
1a, 2a, 3a, 4a,
below, and the amount on that line for the return being filed with this form was blank, then leave line
1b, 2b, 3b, 4b,
whichever is applicable, blank (do not enter -0-). But, if you entered -0- on the return, then enter -0- on the applicable line below.
than 1 line in Part I.
Form 990 check here
b Total revenue,
if any (Form 990, Part VIII, column (A), line 12)~~~~~~~
Form 990-EZ check here
b Total revenue,
if any (Form 990-EZ, line 9) ~~~~~~~~~~~~~~
Form 1120-POL check here
b Total tax
(Form 1120-POL, line 22) ~~~~~~~~~~~~~~~~
Form 990-PF check here
b Tax based on investment income
(Form 990-PF, Part VI, line 5)
Form 8868 check here
b Balance Due
(Form 8868, Part I, line 3c or Part II, line 8c)
Declaration and Signature Authorization of Officer
Under penalties of perjury, I declare that I am an officer of the above organization and that I have examined a copy of the organization's 2015
electronic return and accompanying schedules and statements and to the best of my knowledge and belief, they are true, correct, and complete. I
further declare that the amount in Part I above is the amount shown on the copy of the organization's electronic return. I consent to allow my
intermediate service provider, transmitter, or electronic return originator (ERO) to send the organization's return to the IRS and to receive from the IRS
an acknowledgement of receipt or reason for rejection of the transmission,
the reason for any delay in processing the return or refund, and
the date of any refund. If applicable, I authorize the U.S. Treasury 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 organization's federal taxes owed on this
return, and the financial institution to debit the entry to this account. To revoke a payment, I must contact the U.S. Treasury Financial Agent at
1-888-353-4537 no later than 2 business days prior to the payment (settlement) date. I also authorize the financial institutions involved in the
processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the
payment. I have selected a personal identification number (PIN) as my signature for the organization's electronic return and, if applicable, the
organization's consent to electronic funds withdrawal.
Officer's PIN: check one box only
ANDERSON ZURMUEHLEN & CO., P.C.
to enter my PIN
Enter five numbers, but
ERO firm name
do not enter all zeros
as my signature on the organization's tax year 2015 electronically filed return. If I have indicated within this return that a copy of the return
is being filed with a state agency(ies) regulating charities as part of the IRS Fed/State program, I also authorize the aforementioned ERO to
enter my PIN on the return's disclosure consent screen.
As an officer of the organization, I will enter my PIN as my signature on the organization's tax year 2015 electronically filed return. If I have
indicated within this return that a copy of the return is being filed with a state agency(ies) regulating charities as part of the IRS Fed/State
program, I will enter my PIN on the return's disclosure consent screen.
Officer's signature |
Certification and Authentication
Enter your six-digit electronic filing identification
number (EFIN) followed by your five-digit self-selected PIN.
do not enter all zeros
I certify that the above numeric entry is my PIN, which is my signature on the 2015 electronically filed return for the organization indicated above. I
confirm that I am submitting this return in accordance with the requirements of
Modernized e-File (MeF) Information for Authorized IRS
Providers for Business Returns.
ERO's signature |
ERO Must Retain This Form - See Instructions
Do Not Submit This Form To the IRS Unless Requested To Do So
For Paperwork Reduction Act Notice, see instructions.
13340919 792194 141677
2015.04020 CANCER SUPPORT COMMUNITY MO 141677_1