Form 8453 - California Individual Income Tax Declaration For E-File - 1998

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Declaration Control Number (DCN)

0 0

—

TAXABLE YEAR

FORM

1998

California Individual Income Tax Declaration for e-file

8453

Your first name and initial

Last name

Your social security number

USE

If joint return, also give spouse’s name and initial

Last name

Spouse’s social security number

LABEL

Otherwise

Present home address — number and street including PO Box or rural route

Apt. no.

Daytime telephone number

please print

(

)

or type

City, town or post office, state and ZIP Code

Tax Return Information

Part I

Refund. (Form 540, line 60 or Form 540A, line 35; Form 540EZ, line 35 or Form 540NR, line 69) . . . . . . . . . . . . . . . .

Amount you owe (Form 540, line 61, Form 540A, line 36; Form 540EZ, line 36 or Form 540NR, line 70) . . . . . . . . . . . .

Amount to be automatically withdrawn . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2b Date of the automatic withdrawal. . . . . . . . . . . . . . . . . . . . . . .

(MM / DD / YY) 2b

Part II

Direct Deposit or Automatic Withdrawal

Routing transit number

The first two digits of the routing transit number must be 01 through 12 or 21 through 32.

Depositor account number

Type of account:

Checking

Savings

Declaration of Taxpayer

Part III

I consent that my refund be directly deposited or my payment due be automatically withdrawn as designated in Part II. If I have filed a joint return, this is an

irrevocable appointment of the other spouse as an agent to receive the refund or authorize an automatic withdrawal.

Under penalties of perjury, I declare that the information I provided to my electronic return originator (ERO) or transmitter, including my address and social security number

and the amounts shown in Part I above, agrees with the information and amounts shown on the corresponding lines of my 1998 California income tax return. To the

best of my knowledge and belief, my return is true, correct and complete. If I filed a balance due return, I understand that if Franchise Tax Board (FTB) does not receive

full and timely payment of my tax liability, I remain liable for the tax liability and all applicable interest and penalties. I consent that my return and accompanying schedules

and statements be transmitted to the FTB by my ERO or transmitter. If the processing of my return or refund is delayed, I authorize the FTB to disclose to my

ERO and/or the transmitter the reason(s) for the delay or the date when the refund was sent.

Sign

Here

It is unlawful

Your signature

Date

Spouse’s signature. If filing joint, both must sign.

Date

to forge a

spouse’s

For Privacy Act Notice, see form FTB 1131

signature.

Part IV

Declaration of Electronic Return Originator (ERO) and Paid Preparer. See instructions.

I declare that I have reviewed the above taxpayer’s return and that the entries on form FTB 8453 are complete and correct to the best of my knowledge. If I am only a

collector, I understand that I am not responsible for reviewing the taxpayer’s return. I declare, however, that form FTB 8453 accurately reflects the data on the return. I

have obtained the taxpayer’s signature on form FTB 8453 before transmitting this return to the FTB; I have provided the taxpayer with a copy of all forms and information

to be filed with the FTB and I have followed all other requirements described in FTB Pub. 1345, e-file Handbook for State of California Individual Income Tax Returns. I

will keep form FTB 8453 on file for 4 years from the due date of the return and I will make a copy available to the FTB upon request. 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.

ERO’s

Date

Check if

Check

ERO’s social security number

ERO’s

signature

also paid

if self-

preparer

employed

Use

Firm’s name (or yours

Only

FEIN

if self-employed)

and address

ZIP Code

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. Declaration of preparer is based on all information of which the preparer has any knowledge.

Paid

Date

Check

Paid preparer’s social security number

preparer’s

if self-

Paid

signature

employed

Preparer’s

Firm’s name (or yours