Form R-8453 "Individual Income Tax Declaration for Electronic Filing" - Louisiana

Form R-8453 or the "Individual Income Tax Declaration For Electronic Filing" is a form issued by the Louisiana Department of Revenue.

The form was last revised in January 1, 2019 and is available for digital filing. Download an up-to-date Form R-8453 in PDF-format down below or look it up on the Louisiana Department of Revenue Forms website.

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Download Form R-8453 "Individual Income Tax Declaration for Electronic Filing" - Louisiana

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Louisiana
R-8453 (1/19)
LA 8453
2018 Individual Income Tax Declaration for Electronic Filing
Your first name and initial
Last name
Your Social
1
Security
Number
Spouse’s first name and initial
Last name
Spouse’s
2
Social Security
2018
Number
Present home address (number and street including apartment number or rural route)
Daytime
Telephone
Number
City, town, or post office
State
ZIP
Part A
Tax Return Information
,
.
,
.
,
,
Balance Due
00
Refund Due
00
Part B
Direct Deposit of Refund (Optional)
or Direct Debit (Optional)
Routing Number The first 2 digits of the routing
number must be 01 through 12 or 21 through 32.
Direct Debit Payment
,
.
,
00
Account Number
Withdrawal Date
MM
DD
YYYY
Full Payment
Partial Payment
Type of Account:
Checking
Savings
(Check one.)
Payment made/will be made by credit card.
PART C
Declaration of Taxpayer
I consent that my refund be directly deposited as designated in Part B, and declare that the information shown in Part B is correct. If
I have filed a joint return, this is an irrevocable appointment of the other spouse as an agent to receive the refund.
I do not want direct deposit of my refund, am a first-time filer with Louisiana, or am not receiving a refund. I understand that by not
having my refund direct deposited I will receive my refund by paper check.
I authorize the Louisiana Department of Revenue and its designated Financial Agent to initiate an ACH electronic funds withdrawal
(direct debit) entry to the financial institution account indicated in Part B for payment of my state taxes owed on this return. I also
authorize the financial institutions involved in processing the electronic payment of taxes to receive confidential information neces-
sary to answer inquiries and resolve issues related to the payment.
I understand that if I have filed a balance due return and if the Louisiana Department of Revenue does not receive full and timely
payment of my tax liability, I will remain liable for the tax liability and all applicable interest and penalties.
I declare that I have examined my state income tax return prepared for electronic transmission to the State of Louisiana and, to
the best of my knowledge and belief, it is true and complete.
Please sign here. _________________________
__________
____________________________
______________
Your signature
Date
Spouse’s signature (if joint return)
Date
Do Not Mail
Part D
Declaration and Signature of Electronic Return Originator (ERO) and Paid Preparer
I declare that I have reviewed the above taxpayer’s return and that the entries on the return are complete and correctly represented to
the best of my knowledge based on the information submitted/furnished by the taxpayer. I also declare that I have complied with all of the
requirements of the Louisiana Department of Revenue and in the Louisiana Handbook for Electronic Filers.
Please sign here. _________________________
__________________________________
_____________
__________________________
Preparer’s signature
Social Security Number or ID Number
Date
Telephone
Mark box
if also ERO. ___________________________
__________________________________
_____________
__________________________
Electronic Return Originator’s signature
Social Security Number or ID Number
Date
Telephone
This form is to be maintained by ERO.
Louisiana
R-8453 (1/19)
LA 8453
2018 Individual Income Tax Declaration for Electronic Filing
Your first name and initial
Last name
Your Social
1
Security
Number
Spouse’s first name and initial
Last name
Spouse’s
2
Social Security
2018
Number
Present home address (number and street including apartment number or rural route)
Daytime
Telephone
Number
City, town, or post office
State
ZIP
Part A
Tax Return Information
,
.
,
.
,
,
Balance Due
00
Refund Due
00
Part B
Direct Deposit of Refund (Optional)
or Direct Debit (Optional)
Routing Number The first 2 digits of the routing
number must be 01 through 12 or 21 through 32.
Direct Debit Payment
,
.
,
00
Account Number
Withdrawal Date
MM
DD
YYYY
Full Payment
Partial Payment
Type of Account:
Checking
Savings
(Check one.)
Payment made/will be made by credit card.
PART C
Declaration of Taxpayer
I consent that my refund be directly deposited as designated in Part B, and declare that the information shown in Part B is correct. If
I have filed a joint return, this is an irrevocable appointment of the other spouse as an agent to receive the refund.
I do not want direct deposit of my refund, am a first-time filer with Louisiana, or am not receiving a refund. I understand that by not
having my refund direct deposited I will receive my refund by paper check.
I authorize the Louisiana Department of Revenue and its designated Financial Agent to initiate an ACH electronic funds withdrawal
(direct debit) entry to the financial institution account indicated in Part B for payment of my state taxes owed on this return. I also
authorize the financial institutions involved in processing the electronic payment of taxes to receive confidential information neces-
sary to answer inquiries and resolve issues related to the payment.
I understand that if I have filed a balance due return and if the Louisiana Department of Revenue does not receive full and timely
payment of my tax liability, I will remain liable for the tax liability and all applicable interest and penalties.
I declare that I have examined my state income tax return prepared for electronic transmission to the State of Louisiana and, to
the best of my knowledge and belief, it is true and complete.
Please sign here. _________________________
__________
____________________________
______________
Your signature
Date
Spouse’s signature (if joint return)
Date
Do Not Mail
Part D
Declaration and Signature of Electronic Return Originator (ERO) and Paid Preparer
I declare that I have reviewed the above taxpayer’s return and that the entries on the return are complete and correctly represented to
the best of my knowledge based on the information submitted/furnished by the taxpayer. I also declare that I have complied with all of the
requirements of the Louisiana Department of Revenue and in the Louisiana Handbook for Electronic Filers.
Please sign here. _________________________
__________________________________
_____________
__________________________
Preparer’s signature
Social Security Number or ID Number
Date
Telephone
Mark box
if also ERO. ___________________________
__________________________________
_____________
__________________________
Electronic Return Originator’s signature
Social Security Number or ID Number
Date
Telephone
This form is to be maintained by ERO.
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