Form 8879-K Draft - Kentucky Individual Income Tax Declaration For Electronic Filing - 2013

ADVERTISEMENT

DO NOT MAIL! RETAIN FOR YOUR RECORDS.
K
I
I
t
8879-K
entucKy
ndIvIdual
ncome
ax
d
F
e
F
2013
eclaratIon
or
lectronIc
IlIng
42A740-S22
Department of Revenue
}
Submission Identification Number (SID)
Taxpayer’s Name
Taxpayer’s Social Security number
Spouse’s Name
Spouse’s Social Security number
PART I—Tax Return Information (Whole Dollars Only)
A
B
Spouse
Taxpayer
K
1. Kentucky taxable income
740, line 11
740-NP, line 13
1
.00
.00
E
2. Total tax liability
740, line 28
740-NP, line 28
2
.00
3. Total payments
740, line 31
740-NP, line 31
3
.00
N
4. Refunded to you
740, line 40
740-NP, line 40
4
.00
5. Amount you owe
740, line 44
740-NP, line 44
5
.00
T
PART II—
Direct Deposit of Refund or
Direct Debit of Tax Amount Due (See Instructions)
U
The first two numbers of the RTN must be
01 through 12 or 21 through 32.
6. Routing transit number (RTN)
C
7. Depositor account number (DAN)
K
 
__ __ / __ __ / __ __ __ __
8. Type of account:
Savings
Checking
9. Debit amount ___________________________ Debit date
M M
D D
Y Y Y Y
10. In order to comply with electronic banking regulations, please answer the following questions.
Y
a.
Direct Deposit—Will these funds be going to an account outside of the United States?
Yes   No 
b.
Direct Debit—Will these funds come from an account located outside of the United States?
Yes   No 
PART III—Declaration of Taxpayer (Sign only after Part I is completed.)
11. 
I consent that my refund be directly deposited as designated in Part II, and declare that the information shown on lines 6 through 10 is correct.
If I have filed a joint return, this is an irrevocable appointment of the other spouse as an agent to receive the refund.
12. 
I do not want direct deposit of my refund or am not receiving a refund.
13. 
I authorize the Kentucky Department of Revenue and its designated Financial Agent to initiate an ACH electronic funds withdrawal entry to the
financial institution account indicated above for payment of my state taxes owed on this return. To revoke a payment, I must contact the Kentucky
Department of Revenue at (502) 564-4581 no later than two business days prior to the payment (debit) 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.
If I have filed a balance due return, I understand that if the Kentucky Department of Revenue does not receive my full and timely payment of my tax liability,
I will remain liable for the tax liability and all applicable interest and penalties.
Under penalties of perjury, I declare that the information I have given my electronic return originator (ERO) or transmitter and the amounts in Part I above
agree with the amounts on the corresponding lines of the electronic portion of my 2013 Kentucky income tax return. To the best of my knowledge and
belief, my return is true, correct and complete. I consent to my ERO or transmitter sending my return and accompanying schedules and statements to
the Kentucky Department of Revenue. I also consent to the Kentucky Department of Revenue sending my ERO and/or transmitter an acknowledgment of
receipt or transmission and an indication of whether or not my return is accepted, and, if rejected, the reason(s) for the rejection.
Your Signature (If joint or combined return, both must sign)
Spouse’s Signature
Telephone Number (daytime)
Date Signed
PART IV—Declaration and Signature of Electronic Return Originator and Paid Preparer
I declare that I have reviewed the above taxpayer’s return and that the entries on Form 8879-K 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 this return. If Part II is
completed, I declare that I have verified the taxpayer’s proof of account and it agrees with the name shown on this form. The taxpayer will have signed
this form before I submit the return. I will give the taxpayer a copy of all forms and information to be filed with the Kentucky Department of Revenue, and
have followed all other requirements in Kentucky Publication KY-1345, Kentucky Handbook for Electronic Filers of Individual Income Tax Returns (Tax Year
2013). If I am also the paid preparer, under penalties of perjury I declare that I have examined the above taxpayer’s return and accompanying schedules
and statements, and to the best of my knowledge and belief, they are true, correct and complete. This declaration is based on all information of which I
have any knowledge.
Check
if also paid preparer.
Check
if self-employed.
ERO’s
Use Only
Signature
Date
I.D. Number of ERO
Firm’s name (or
FEIN
yours if self-employed)
ZIP code
and address
Paid Preparer’s
Check
if self-employed.
Use Only
Preparer’s Signature
Date
I.D. Number of Preparer
Firm’s name (or
FEIN
yours if self-employed)
and address
ZIP code
➤ Keep this form with your tax return. Do not mail!

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 2