Form Ga-8453p - Georgia Partnership Tax Return Declaration For Electronic Filing - Summary Of Agreement Between Taxpayer And Ero Or Paid Prepayer - 2016
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1PRINT
CLEAR
ERO MUST RETAIN THIS FORM.
DO NOT SUBMIT THIS FORM TO
GEORGIA DEPARTMENT OF REVENUE
UNLESS REQUESTED TO DO SO.
GA-8453P
IRS DCN OR SUBMISSION ID
2016
GEORGIA PARTNERSHIP TAX RETURN DECLARATION FOR ELECTRONIC FILING
SUMMARY OF AGREEMENT BETWEEN TAXPAYER AND ERO OR PAID PREPARER
Beginning____________________20____, and Ending____________________20____
Original Return
Amended Return
Final Return
Change of Address
Composite Return
Name Change
Number of Partners
FEI Number
Name
Resident
Non-Resident
GA Withholding Tax Acct. Number
B
s u
n i
e
s s
A
d
d
e r
s s
Country
Telephone Number
Payroll WH Number Nonresident WH Number
GA Sales Tax Reg. Number
City or Town
State
Zip Code
NAICS Code
Kind of Business
Location of Books for Audit (City & State)
P
I
TAX RETURN INFORMATION
ART
1. Total Income for Georgia purposes (Schedule 1, Line 1) ...................................................
1. _____________________________
2. Total Georgia net income (Schedule 1, Line 7) ...................................................................
2. _____________________________
P
II
DECLARATION OF PARTNER
ART
Under the penalty of perjury, I declare that I am a general partner or limited liability company member of the above partnership and the information
I have provided to my Electronic Return Originator (ERO) and/or Online Service Provider and/or Transmitter, the amounts shown in Part I agree with
the amounts shown on the corresponding lines of the electronic portion of my 2016 Georgia Partnership Tax Return. I declare that I have examined
my tax return, including accompanying schedules and statements, and to the best of my knowledge and belief, my return is true, correct and complete.
I consent that the electronic portion of my return may be sent to the IRS by my ERO/Online Service Provider/Transmitter.
S
IGN
H
ERE
Signature of Partner
Date
E-mail Address
P
III
DECLARATION OF ELECTRONIC RETURNS ORIGINATOR AND PAID PREPARER
ART
I DECLARE THAT I HAVE REVIEWED THE ABOVE TAXPAYER’S RETURN AND THAT THE ENTRIES ON THE GA-8453P ARE COMPLETE
AND CORRECT TO THE BEST OF MY KNOWLEDGE.
ERO’s Signature _____________________________________________________________
Date ______________________________
ERO’
S
Firm’s Name
_______________________________________________________________
Check also if paid preparer
U
SE
O
NLY
Address
_______________________________________________________________
FEIN/PTIN _________________________
City, State & Zip Code ____________________________________________________________ SSN/TIN ___________________________
IF PREPARED BY A PERSON OTHER THAN THE TAXPAYER, THIS DECLARATION IS BASED ON ALL THE INFORMATION OF WHICH
THE TAXPAYER HAS KNOWLEDGE.
Paid Preparer’s Signature _____________________________________________________
Date ______________________________
P
AID
Firm’s Name
_______________________________________________________________
FEIN/PTIN _________________________
P
’
REPARER
S
U
O
SE
NLY
Address
_______________________________________________________________
SSN/TIN ___________________________
City, State & Zip Code _____________________________________________________________
KEEP A COPY WITH YOUR RECORDS
GA-8453P (Rev. 09/26/16)
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