Form Pa-8453f "Pennsylvania Fiduciary Income Tax Declaration for Electronic Filing" - Pennsylvania

Form PA-8453F or the "Pennsylvania Fiduciary Income Tax Declaration For Electronic Filing" is a form issued by the Pennsylvania Department of Revenue.

Download a PDF version of the Form PA-8453F down below or find it on the Pennsylvania Department of Revenue Forms website.

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Declaration Control Number/Submission ID
START
PA DEPARTMENT OF REVENUE USE ONLY –
DO NOT WRITE OR STAPLE IN THIS SPACE
PA-8453F
PENNSYLVANIA FIDUCIARY INCOME TAX
2018
Form
DECLARATION FOR ELECTRONIC FILING
(EX) 04-18
MMDD
MMDD
For Calendar Year 2018, or Fiscal Year Beginning,
, 2018 and Ending,
, 20
Name of Estate or Trust
Employer Identification Number
Name and Title of Fiduciary
Print
or
Address (Number and Street including Rural Route or P.O. Box)
Type
City, Town or Post Office
State
ZIP Code
The above information must match that on the electronic return exactly.
P
Part I
Tax Return Information (Enter whole dollars only.)
1. Net PA taxable income (Form PA-41, Line 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.
E
2. PA tax liability (Form PA-41, Line 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.
3. Total Payments and Credits (Form PA-41, Line 18) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.
N
4. Overpayment (Form PA-41, Line 23) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.
5. Total payment (tax due) (Form PA-41, Line 22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.
N
Part II
Direct Deposit of Refund or Electronic Funds Withdrawal of Tax Due (Optional – See instructions.)
The first two numbers of the RTN must
S
6. Routing transit number (RTN)
be 01 through 12 or 21 through 32.
7. Depositor account number (DAN)
Y
£
£
8. Type of account:
Checking
Savings
L
MMDDYYYY
.
9
Debit date
Part III
Declaration of Fiduciary (Sign only after Part I is complete.)
£
V
a.
10.
I consent for the refund from the 2018 PA-41, Fiduciary Income Tax Return, to be directly deposited as designated in Part II and declare all information
£
shown on Lines 6 through 8 is correct. I certify the ultimate destination of the funds is within the U.S or one of its territories.
A
£
b.
The estate or trust is not receiving a refund or I do not want direct deposit of the refund.
c.
I authorize the PA Department of Revenue and its designated financial agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the
financial institution account indicated for payment of the estate’s or trust’s taxes owed on this return, and I authorize the financial institution to debit the
N
entry to this account. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential
information necessary to answer inquires and resolve issues related to the payment. To revoke a payment, I may revoke this authorization by
notifying the PA Department of Revenue no later than two business days prior to the payment (settlement) date. I understand notification must be
made in writing by e-mail to ra-achrevok@pa.gov or by fax to 717-772-9310.
I
Under penalties of perjury, I declare that the amounts above match the amounts shown on the corresponding lines of the electronic portion of the 2018 PA-41, Fiduciary Income
Tax Return. I have also examined a copy of the return being filed electronically with the PA Department of Revenue and all accompanying schedules and statements. To the
best of my knowledge and belief, they are true, correct and complete. If I am not the transmitter, I consent that the return and accompanying schedules and statements be
A
sent to the PA Department of Revenue by the transmitter. I also consent to the PA Department of Revenue sending the ERO and/or transmitter an acknowledgement of receipt
of transmission and an indication of whether or not the return is accepted, and if rejected, the reason(s) for the rejection.
MMDDYYYY
Signature of Officer – Please sign after printing
Sign
Signature of Fiduciary or Officer
Date
Here
Part
IV
Declaration of Electronic Return Originator (ERO) and Paid Preparer (See instructions.)
I declare that I have reviewed the above-referenced estate or trust return and that the entries on PA-8435F are complete and correct to the best of my knowledge. If I am only
a collector, I am not responsible for reviewing the return, and only declare that this form accurately reflects the data on the return. The fiduciary or an officer representing the
fiduciary will have signed this form before I submit the return. I will give the fiduciary or officer representing the fiduciary a copy of all forms and information to be filed with the
PA Department of Revenue, and I have followed all other requirements described in REV-993, Pennsylvania Fed/State E-file Handbook. If I am also the paid preparer, under
penalties of perjury, I declare that I have examined the above-referenced estate or trust 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.
£
£
MMDDYYYY
Check if
ERO’s signature
Date
Check if also
EIN/SSN or PTIN
self-employed
paid preparer
Signature of ERO – Sign after printing
ERO’s
Use
FIRM NAME AND ADDRESS
Firm’s name (or yours,
Only
if self-employed) and
NO DASHES
CITY
STATE
ZIP CODE
address
Daytime Telephone Number (
)
£
£
MMDDYYYY
Check if also
Preparer’s signature
Date
Check if
EIN/SSN or PTIN
Signature of Preparer – Please sign after printing
paid preparer
self-employed
Paid
Preparer’s
FIRM NAME AND ADDRESS
Firm’s name (or yours,
Use Only
if self-employed) and
NO DASHES
address
CITY
ZIP CODE
STATE
Daytime Telephone Number (
)
Please DO NOT mail this form.
Reset Entire Form
TOP OF PAGE
NEXT PAGE
PRINT
Declaration Control Number/Submission ID
START
PA DEPARTMENT OF REVENUE USE ONLY –
DO NOT WRITE OR STAPLE IN THIS SPACE
PA-8453F
PENNSYLVANIA FIDUCIARY INCOME TAX
2018
Form
DECLARATION FOR ELECTRONIC FILING
(EX) 04-18
MMDD
MMDD
For Calendar Year 2018, or Fiscal Year Beginning,
, 2018 and Ending,
, 20
Name of Estate or Trust
Employer Identification Number
Name and Title of Fiduciary
Print
or
Address (Number and Street including Rural Route or P.O. Box)
Type
City, Town or Post Office
State
ZIP Code
The above information must match that on the electronic return exactly.
P
Part I
Tax Return Information (Enter whole dollars only.)
1. Net PA taxable income (Form PA-41, Line 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.
E
2. PA tax liability (Form PA-41, Line 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.
3. Total Payments and Credits (Form PA-41, Line 18) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.
N
4. Overpayment (Form PA-41, Line 23) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.
5. Total payment (tax due) (Form PA-41, Line 22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.
N
Part II
Direct Deposit of Refund or Electronic Funds Withdrawal of Tax Due (Optional – See instructions.)
The first two numbers of the RTN must
S
6. Routing transit number (RTN)
be 01 through 12 or 21 through 32.
7. Depositor account number (DAN)
Y
£
£
8. Type of account:
Checking
Savings
L
MMDDYYYY
.
9
Debit date
Part III
Declaration of Fiduciary (Sign only after Part I is complete.)
£
V
a.
10.
I consent for the refund from the 2018 PA-41, Fiduciary Income Tax Return, to be directly deposited as designated in Part II and declare all information
£
shown on Lines 6 through 8 is correct. I certify the ultimate destination of the funds is within the U.S or one of its territories.
A
£
b.
The estate or trust is not receiving a refund or I do not want direct deposit of the refund.
c.
I authorize the PA Department of Revenue and its designated financial agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the
financial institution account indicated for payment of the estate’s or trust’s taxes owed on this return, and I authorize the financial institution to debit the
N
entry to this account. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential
information necessary to answer inquires and resolve issues related to the payment. To revoke a payment, I may revoke this authorization by
notifying the PA Department of Revenue no later than two business days prior to the payment (settlement) date. I understand notification must be
made in writing by e-mail to ra-achrevok@pa.gov or by fax to 717-772-9310.
I
Under penalties of perjury, I declare that the amounts above match the amounts shown on the corresponding lines of the electronic portion of the 2018 PA-41, Fiduciary Income
Tax Return. I have also examined a copy of the return being filed electronically with the PA Department of Revenue and all accompanying schedules and statements. To the
best of my knowledge and belief, they are true, correct and complete. If I am not the transmitter, I consent that the return and accompanying schedules and statements be
A
sent to the PA Department of Revenue by the transmitter. I also consent to the PA Department of Revenue sending the ERO and/or transmitter an acknowledgement of receipt
of transmission and an indication of whether or not the return is accepted, and if rejected, the reason(s) for the rejection.
MMDDYYYY
Signature of Officer – Please sign after printing
Sign
Signature of Fiduciary or Officer
Date
Here
Part
IV
Declaration of Electronic Return Originator (ERO) and Paid Preparer (See instructions.)
I declare that I have reviewed the above-referenced estate or trust return and that the entries on PA-8435F are complete and correct to the best of my knowledge. If I am only
a collector, I am not responsible for reviewing the return, and only declare that this form accurately reflects the data on the return. The fiduciary or an officer representing the
fiduciary will have signed this form before I submit the return. I will give the fiduciary or officer representing the fiduciary a copy of all forms and information to be filed with the
PA Department of Revenue, and I have followed all other requirements described in REV-993, Pennsylvania Fed/State E-file Handbook. If I am also the paid preparer, under
penalties of perjury, I declare that I have examined the above-referenced estate or trust 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.
£
£
MMDDYYYY
Check if
ERO’s signature
Date
Check if also
EIN/SSN or PTIN
self-employed
paid preparer
Signature of ERO – Sign after printing
ERO’s
Use
FIRM NAME AND ADDRESS
Firm’s name (or yours,
Only
if self-employed) and
NO DASHES
CITY
STATE
ZIP CODE
address
Daytime Telephone Number (
)
£
£
MMDDYYYY
Check if also
Preparer’s signature
Date
Check if
EIN/SSN or PTIN
Signature of Preparer – Please sign after printing
paid preparer
self-employed
Paid
Preparer’s
FIRM NAME AND ADDRESS
Firm’s name (or yours,
Use Only
if self-employed) and
NO DASHES
address
CITY
ZIP CODE
STATE
Daytime Telephone Number (
)
Please DO NOT mail this form.
Reset Entire Form
TOP OF PAGE
NEXT PAGE
PRINT
THIS PAGE DOES NOT PRINT
2018
Pennsylvania Department of Revenue
Instructions for PA-8453F
Fiduciary Income Tax Declaration for Electronic Filing
PA-8453F IN (EX) 04-18
code. In the spaces provided, enter
Line 6 - The routing transit number
FILING OF FORM PA-8453F
the employer identification number of
(RTN) must contain nine digits. If the
the estate or trust.
If an estate or trust elects not to
RTN does not begin with 01 through
use the federal self-select PIN or a
12, or 21 through 32, the direct
The address on this form must match
return is filed without a federal return,
deposit or electronic funds withdrawal
the address on the electronically filed
electronic return originators (EROs)
request will be rejected.
PA-41.
and transmitters must retain completed
Line 7 - The depositor account
Forms PA-8453F and supporting
PART I – TAX RETURN
documents for three years after the
number (DAN) may contain up to 17
INFORMATION
due date of the return or the date the
alphanumeric characters. Include
return was filed electronically, whichever
hyphens but omit spaces and special
Line 1 - Enter adjusted PA taxable
is later. EROs and transmitters must
symbols. If fewer than 17 characters,
income from Line 9, Form PA-41.
make the documents available to the
enter the number from left to right and
PA Department of Revenue upon
Line 2 - Enter PA tax liability from
leave the unused boxes blank.
request. Do not mail Form PA-8453F
Line 12, Form PA-41.
and attachments to the PA Department
Line 8 - Check the appropriate box.
Line 3 - Enter total payments and
of Revenue unless requested.
Line 9 - Debit Date - Enter the date
credits from Line 18, Form PA-41.
NOTE: If an ERO or transmitter
the estate or trust wants the payment
Line 4 - Enter the overpayment from
closes its business, it must mail
electronically withdrawn, on or before
Line 23, Form PA-41.
all forms to the following address with
April 15, 2019.
a letter of explanation.
Line 5 - Enter total payment (tax due),
To be eligible for direct deposit or
from Line 22, Form PA-41.
PA DEPARTMENT OF REVENUE
electronic funds withdrawal, estate or
BUREAU OF INDIVIDUAL TAXES
Estates or trusts are responsible for
trust fiduciaries must provide proof of
ELECTRONIC FILING SECTION
submitting payment due to the PA
account ownership to the ERO. An
PO BOX 280507
Department of Revenue by April 15,
acceptable proof of account owner-
HARRISBURG PA 17128-0507
2019.
ship is a check, form, report or other
Any estate or trust fiduciary filing elec-
Payment may be sent along with
statement generated by the financial
tronically from a home computer must
Form PA-41 V. If Form PA-41 V was not
institution that has the estate or trust’s
keep the signed Form PA-8453F and
received, it may be completed online,
name, RTN and DAN preprinted on it.
supporting documents for three years
printed and mailed to the department
after the due date of the return or the
For accounts payable through a finan-
with payment. Check or money order
date the return was filed electronically,
cial institution other than the one at
should be made payable to the
whichever is later. Estates or trust
which the account is located, the estate
PA Dept. of Revenue. The estate or
fiduciaries must make the documents
trust’s employer identification number,
or trust must provide a document,
available to the PA Department of
“2018 PA Tax” and fiduciary’s daytime
such as an account statement or iden-
Revenue upon request. Do not mail
telephone number should be written
tification card, showing the RTN of the
Form PA-8453F and attachments to
on the payment.
bank or institution where the account
the PA Department of Revenue unless
is located. A deposit slip should not be
PA DEPT. OF REVENUE
requested.
used to verify RTN or DAN because it
PAYMENT ENCLOSED
can contain internal routing numbers
LINE INSTRUCTIONS
1 REVENUE PLACE
HARRISBURG PA 17129-0001
that are not part of the RTN.
FORM 8453F
If there is any doubt about the correct
PART II – DIRECT DEPOSIT
Submission ID - The Submission ID
RTN, the estate or trust fiduciary
is a 20-digit number assigned by the
OF REFUND OR
should contact the financial institution
ERO to a taxpayer’s return.
ELECTRONIC FUNDS
for assistance.
Name of Estate or Trust, Name and
WITHDRAWAL
NOTE: Some financial institutions
Title of Fiduciary, Address and
may not accept direct deposits
Employee Identification Number
Estates or trusts may elect to have
into accounts payable through another
Print or type the name of the estate or
refunds directly deposited or payments
bank or financial institution, including
trust, the name and title of the fiduciary
made by electronic funds withdrawal
and the complete address including ZIP
by completing Part II.
credit unions.
www.revenue.pa.gov
PA-8453F
1
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faxed to 717-772-9310 or emailed to
PART III – DECLARATION
PART IV – DECLARATION
ra-achrevok@pa.gov.
OF TAXPAYER
OF ELECTRONIC RETURN
After a return has been prepared and
ORIGINATOR (ERO)
before the return is transmitted, the
Line 10 - All filers must check one of
AND PREPARER
estate or trust fiduciary must verify the
the boxes.
information on the return and sign and
NOTE: Estates or trusts may
The ERO must sign this form and
date the completed Form PA-8453F.
revoke the electronic funds with-
keep it with the required attachments
The ERO must provide the estate or
drawal authorization by notifying the
for three years.
trust fiduciary with a copy of this form.
PA Department of Revenue in writing
A preparer must sign the Form
If the ERO makes changes to the
no later than two business days prior
PA-8453F in the space for Preparer. If
electronic return after the Form
to the debit date. Written requests to
the preparer is also the ERO, do not
PA-8453F has been signed by the
revoke the electronic funds withdrawal
complete the Preparer Section;
estate or trust fiduciary, but before it is
must include the estate or trust’s name,
instead, check the box labeled “Check
transmitted, the ERO must have the
the name and title of the fiduciary, the
if also paid preparer.”
estate or trust fiduciary complete and
address, the employer identification
sign a corrected Form PA-8453F.
number, RTN, DAN and payment
amount. Written requests can be
2
PA-8453F
www.revenue.pa.gov
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