Form Ga-8453 S - Georgia S Corporate Income Tax Declaration For Electronic Filing - Summary Of Agreement Between Taxpayer And Ero Or Paid Preparer

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CLEAR
ERO MUST RETAIN THIS FORM
DO NOT SUBMIT THIS FORM TO
GEORGIA DEPARTMENT OF REVENUE
UNLESS REQUESTED TO DO SO.
IRS DCN OR SUBMISSION ID
GA-8453 S
2014
GEORGIA S CORPORATE INCOME TAX DECLARATION FOR ELECTRONIC FILING
SUMMARY OF AGREEMENT BETWEEN TAXPAYER AND ERO OR PAID PREPARER
Initial Net Worth
UET Annualization Exception attached
Extension
C Corp Last Year
2014
2015
Income Tax Return
Net Worth Return
Composite Return Filed
Name Change
Beginning ____________________
Beginning ____________________
Original Return
Address Change
Ending
_____________________
Ending
_____________________
Amended Return
Final
Federal Employer I.D. Number
Name (Corporate title)
Date admitted into GA
Location of Books (City & State)
Business Address
Incorporated under laws of
what state
Telephone Number
City or Town
State
Zip Code
NAICS Code
P
I
TAX RETURN INFORMATION
ART
1. Federal ordinary income
(Form 600S, Line J) ..............................................................................................
1.
2. Total Income for Georgia purposes
(Form 600S, Sch 8, Line 11) ................................................................
2.
3. Net Worth
3.
(Form 600S, Sch 3, Line 4) ...........................................................................................................
4. Net Worth Taxable by Georgia
(Form 600S, Sch 3, Line 6) .........................................................................
4.
5. Tax Amounts
Income
..... Net Worth
(Form 600S, Sch 4, Line 1) ...........
6. Balance of Tax due with return
6.
(Form 600S, Sch 4, Line 10).......................................................................
7. Refund
(Form 600S, Sch 4, Line 11) ...
Credited to 2015
...... Refunded
P
II
DECLARATION OF CORPORATE OFFICER
ART
Under penalties of perjury, I declare that the information I have provided to the corporation’s Electronic Return Originator (ERO) and/or Online Service Provider and/or
transmitter and the amountsshown inPart Iagree withthe amountsshownon the corresponding lines of the electronic portion of the corporation’s 2014 Georgia Corporate
Income Tax Return. I declare that I have examined the corporation’s tax return including, accompanying schedules and 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
H
SIGNATURE OF OFFICER
DATE
ERE
TITLE
PRINT NAME
E-MAIL
P
III
DECLARATION OF ELECTRONIC RETURNS ORIGINATOR AND PAID PREPARER
ART
I DECLARE THAT I HAVE REVIEWED THEABOVE CORPORATION’S RETURNAND THATTHE ENTRIES ON THE GA-8453 SARE 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 KNOWLEDGE.
Paid Preparer’s Signature _________________________________________________________
Date _______________________
Paid
Firm’s Name
__________________________________________________________________
FEIN/PTIN _________________
Preparer’s
Address
__________________________________________________________________
SSN/TIN ___________________
Use Only
__________________________________________________________________
KEEP A COPY WITH YOUR RECORDS
GA-8453 S (REV. 7/14)

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