Looking for a Missouri Tax Forms And Templates? Download it for free!

Missouri Department of Revenue

Do Not Mail

Form

2014 Individual Income Tax Declaration

For Internet Or Electronic Filing

to Department of Revenue

MO-8453

Postmark Date

Cash

Department

Use Only

Name (Last, First, Initial)

Social Security Number

Spouse’s Name (Last, First, Initial)

Spouse’s Social Security Number

Present Address (Rural Route or P.O. Box)

Telephone Number

(__ __ __) __ __ __ - __ __ __ __

City, Town

State

Zip Code

1. Total federal adjusted gross income (Form MO-1040, Line 1) .......................................................................

2. Total Missouri tax (Form MO-1040, Line 31) ..................................................................................................

3. Missouri income tax withheld (Form MO-1040, Line 32)

Department

Form W-2(s) and 1099R(s) must be attached ...............................

Use Only

4. Refund (Form MO-1040, Line 46) ..................................................................................................................

5. Amount you owe (Form MO-1040, Line 49). Please mail amount due with Form MO-1040V to:

Missouri Department of Revenue, P.O. Box 371, Jefferson City, MO 65105-0371 or

dial (888) 929-0513 to pay with major credit card. .........................................................................................

Under penalties of perjury, I declare that the information I have provided to my electronic return originator (ERO) or entered via the Internet agree with the amounts

shown on the corresponding lines of my 2014 Missouri Individual Income Tax Return and with Part 1 above. To the best of my knowledge and belief, my return is true,

correct, and complete. I consent that my return and accompanying schedules and statements, if electronically filed, be sent to the Internal Revenue Service (IRS) by

my ERO and by the IRS to the Missouri Department of Revenue. I consent that my return and accompanying schedules and statements, if filed via the Internet, will be

retained by me for three years. If I have filed a balance due return, I understand that if the Department does not receive full and timely payment of my tax liability, I will

remain liable for the tax liability and applicable interest and additions to tax. If I have filed a joint Federal and State tax return and there is an error on my Federal return,

I understand my Missouri return may not be forwarded to the Department. If the processing of my return or refund is delayed, I authorize the Department to disclose to

my ERO, practitioner, or the transmitter the reason(s) for the delay, or when the refund was sent.

I declare, under the penalties of perjury, that I agree to provide the direct deposit information to the Department so my refund check may be deposited into the account

specifically designated. I agree that the Department will not be liable for misrouting of direct deposit based upon incorrect account information provided by myself or

the ERO.

Direct Deposit

Yes

Signature

Date (MM/DD/YYYY)

Spouse’s Signature (if filing combined, both must sign) Date (MM/DD/YYYY)

__ __ /__ __ /__ __ __ __

I declare that I have reviewed the above taxpayer’s return and that the entries on Form MO-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 that Form MO-8453 accurately reflects the data on the return. I have

obtained the taxpayer’s signature on Form MO-8453 before submitting this return to the Missouri Department of Revenue, have provided the taxpayer with a copy of all

forms and information to be filed with the Missouri Department of Revenue and have followed all other requirements described in the Missouri Handbook for Electronic

Filers and any requirements specified by the Missouri Department of Revenue. 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.

This declaration of Paid Preparer is based on all information of which the preparer has any knowledge.

I declare that the direct deposit information transmitted electronically was provided by the taxpayer. I agree I will be liable for reimbursement to the taxpayer or the

Missouri Department of Revenue if the direct deposit is misrouted based on this information and cannot be recovered.

ERO Use Only

ERO’s Signature

Date (MM/DD/YYYY)

Paid Preparer

Self Employed

Social Security Number

_ _ / _ _ / _ _ _ _

Firm’s Name (Your name if self-employed)

Telephone Number

Employer Identification Number

(_ _ _) _ _ _ - _ _ _ _

Address

City

State

Zip Code

Paid Preparer Use Only

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.

Preparer’s Signature

Date (MM/DD/YYYY)

Self-Employed

Social Security Number

_ _ / _ _ / _ _ _ _

Firm’s Name (Your name if self-employed)

Telephone Number

Employer Identification Number

(_ _ _) _ _ _ - _ _ _ _

Address

City