Form Nj-8879 - Nj E-File Signature Authorization - 2015
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1
2NJ-8879
NJ e-file Signature Authorization
2004
Do not send to New Jersey. Keep for your records.
2015
Department of the Treasury
See instructions.
Division of Revenue
Taxpayer’s name
Social security number
Do not mail the NJ-8879 to New Jersey
Spouse’s name
Spouse’s social security number
or Civil Union Prtnr's
or Civil Union Prtnr's
Part I
Tax Return Information—Tax Year Ending December 31, 2004 (Whole Dollars Only)
2015
1
1
New Jersey Taxable income (Form NJ-1040, line 37)
from (Form NJ-1040, line 39) (Form NJ1040nr, line 37)
(Form NJ-1040NR, Line 34)
2
2
Total tax (Form NJ-1040, line 42)
(Form NJ-1040NR, Line 38)
from (Form
NJ-1040, line 47) (Form NJ1040nr, line 44)
3
3
New Jersey income tax withheld (Form NJ-1040, line 43)
(Form NJ-1040NR, Line 39)
from (Form
NJ-1040, line 48) (Form NJ1040nr, line 45)
4
4
Refund (Form NJ-1040, line 60)
from (Form
NJ-1040, line 66) (Form NJ1040nr, line 56)
(Form NJ-1040NR, Line 49)
5
Amount you owe (Form NJ-1040, line 50)
from (Form
NJ-1040, line 56) (Form NJ1040nr, line 52)
(Form NJ-1040NR, Line 45)
5
Part II
Declaration and Signature Authorization of Taxpayer
Under penalties of perjury, I declare that I have examined a copy of my electronic individual income tax return and accompanying
2015
schedules and statements for the tax year ending December 31, 2004, and to the best of my knowledge and belief, it is true,
correct, and complete. I further declare that the amounts in Part I above are the amounts shown on the copy of my electronic
income tax return. I acknowledge that I have read the Consent to Disclosure and, if applicable, Electronic Funds Withdrawal Consent
included on the copy of my electronic income tax return and I agree to the provisions contained therein. I have selected a personal
identification number (PIN) as my signature for my electronic income tax return and, if applicable, my Electronic Funds Withdrawal
Consent.
Taxpayer’s PIN: check one box only
I authorize
to enter my PIN
as my signature
ERO firm name
do not enter all zeros
on my tax year 2004 electronically filed income tax return.
2015
I will enter my PIN as my signature on my tax year 2004 electronically filed income tax return. Check this box only if you
2015
are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III
below.
Your signature
Date
Spouse’s PIN: check one box only
(or Civil Union Prtnr's PIN)
I authorize
to enter my PIN
as my signature
ERO firm name
do not enter all zeros
on my tax year 2004 electronically filed income tax return.
2015
I will enter my PIN as my signature on my tax year 2004 electronically filed income tax return. Check this box only if you
2015
are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III
below.
Spouse’s signature
Date
or Civil Union Prtnr's
Practitioner PIN Method Returns Only—continue below
Part III
Certification and Authentication—Practitioner PIN Method
ERO’s EFIN/PIN. Enter your six-digit 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 tax year 2004 electronically filed income tax
2015
return for the taxpayer(s) indicated above. I confirm that I am submitting this return in accordance with the requirements of
the Practitioner PIN method.
ERO’s signature
Date
ERO Must Retain This Form — See Instructions
Do Not Submit This Form to New Jersey Unless Requested To Do So
NJ-8879
2015
Form
(2004)
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