Form Ga-8453c - Corporate Income Tax Declaration For Electronic Filing Summary Of Agreement Between Taxpayer And Ero Or Paid Preparer - 2011
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1
2KEEP WITH YOUR RECORDS
IRS DCN OR SUBMISSION ID
GA-8453 C
2011
GEORGIA CORPORATE INCOME TAX DECLARATION FOR ELECTRONIC FILING
SUMMARY OF AGREEMENT BETWEEN TAXPAYER AND ERO OR PAID PREPARER
Consolidated GA Subsidiary
Address Change
Consolidated Parent FEIN
Name Change
2011
2012
Final
Income Tax Return
Net Worth Return
Consolidated GA Parent
IT-552
Beginning ____________________
Beginning ____________________
Original Return
Initial Net Worth
Ending
_____________________
Ending
_____________________
Amended Return
Extension
Federal Employer I.D. Number
Name (Corporate
l t i t
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D
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into GA
Location of Books (City & State)
Business Address
Incorporated under laws of
what state
Telephone Number
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ART
1. Federal taxable income
1.
(Form 600, Sch 1, Line 1) ......................................................................................
2. Georgia taxable income
2.
(Form 600, Sch 1, Line 7) .....................................................................................
3. Net Worth
(Form 600, Sch 2, Line 4) ............................................................................................................
3.
4. Net Worth Taxable by Georgia
4.
(Form 600, Sch 2, Line 6) ..........................................................................
5. Tax Amounts
Income
..... Net Worth
(Form 600, Sch 3, Line 1) ............
6. Balance of Tax due with return
6.
(Form 600, Sch 3, Line 10)........................................................................
7. Refund
Credited to 2012
...... Refunded
(Form 600, Sch 3, Line 11) ....
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Under penaltiesof perjury, I declare that the informationI have provided to the corporation’s ElectronicReturn Originator(ERO) and/or Online Service Provider and/or transmitter
and the amounts shown in Part I agree with the amounts shown on the correspondinglines of the electronic portionof the corporation’s 2011 Georgia CorporateIncomeTax Return.
I declarethat I have examinedthe corporation’s tax return,includingaccompanyingschedulesand statements, and to the best of my knowledge and belief, the corporation’s return is
true, correct and complete. I consent that the electronic portion of the corporation’s return may be sent by my ERO/Online Service Provider/transmitter.
S
IGN
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III
DECLARATION OF ELECTRONIC RETURNS ORIGINATOR AND PAID PREPARER
ART
I DECLARE THAT I HAVE REVIEWED THEABOVE CORPORATION’S RETURNAND THAT THE ENTRIES ON THE GA-8453 CARE COMPLETE
AND CORRECTTO THE BEST OF MYKNOWLEDGE.
ERO’s Signature _________________________________________________________________
Date _______________________
ERO’s
Firm’s Name
__________________________________________________________________
Check if also paid preparer
Use
Address
__________________________________________________________________
Only
__________________________________________________________________
IF PREPARED BYA PERSON OTHER THAN THE TAXPAYER, THIS DECLARATION IS BASED ON ALL THE INFORMATION OF WHICH
THE TAXPAYER HAS ANY KNOWLEDGE.
Paid Preparer’s Signature _________________________________________________________
Date _______________________
Paid
Firm’s Name
__________________________________________________________________
FEIN/PTIN _________________
Preparer’s
Address
__________________________________________________________________
SSN/TIN ___________________
Use Only
__________________________________________________________________
PLEASE DO NOT MAIL! KEEP WITH YOUR RECORDS
GA-8453 C (REV 8/11)
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