Iowa Corporation Income Tax Return Form
In the case of wanting to know the income tax return, the following form has to be completed and submitted.
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1. Net Income After Additions (IA 1120, line 4)......................................................1.____________________ 2. Income Subject to Tax (IA 1120, line 16) ............................................................2.____________________ 3. Total Tax (IA 1120, line 19) ................................................................................... 3.____________________ 4. Total Amount Due (IA 1120, line 28) ....................................................................4.____________________ 5. Overpayment (IA 1120, line 29) ............................................................................ 5.____________________ 6. I do not want direct deposit or direct debit. 7. I consent that the corporation’s refund be directly deposited as designated below. I authorize the Iowa Department of Revenue (IDR) and its designated financial agent to initiate an electronic funds withdrawal (direct debit) entry to the financial institution account indicated below for payment of the corporation’s Iowa taxes owed on this return, and the financial institution to debit the entry to this account on ______________ (the payment/settlement date) . I also authorize the financial institution involved in the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment. Name of Corporation Federal Employer Identification Number (FEIN) Iowa Corporation Income Tax Declaration for an E-File Return Part I Tax Return Information 2012 IA 8453-C 42-009a (09/24/12) Part II Declaration of Officer (Be sure to keep a copy of the tax return) www.iowa.gov/tax Iowa Department of Revenue Do Not Mail This Form. Retain completed form with your tax records for at least Part III Declaration of Electronic Return Originator (ERO) and Paid Preparer For calendar year 2012 or tax year beginning , 2012, ending , 20 NOTE: This electronic withdrawal from your bank account will be identified with the ACH Company ID 4426004574. If you currently have a debit block on this account, please contact your financial institution to request that they allow a withdrawal from our bank account by this ACH Company ID. I declare that I have reviewed the above corporation’s return and that entries on form IA 8453-C are complete and correct to the best of myknowledge. 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 thereturn. The corporate officer will have signed this return before submitting to the IRS. I have provided the officer with a copy of all forms andinformation to be filed with the IDR and have followed all other requirements described in the Iowa Modernized e-File (MeF) Developer Guide andInformation for e-File Providers. I will keep form IA 8453-C, with attachments, on file for three years from the due date of the return or the filingdate, whichever is later, and I will make a copy available to the IDR upon request. If I am the paid preparer, under penalties of perjury, I declarethat I have examined the above corporation’s return and accompanying schedules and statements, and to the best of my knowledge and belief,they are true, correct, and complete. This declaration is based on all information of which I have any knowledge. Date Check if self-employedERO’s PTIN EROSignature Firm’s name (or yoursif self-employed), address and ZIP code FEIN Check if also paid preparer ERO Use Only Firm’s name (or yours if self-employed), address and ZIP code Date Preparer’s PTIN Paid Preparer’s Signature FEIN Check if self-employed Paid Preparer Use Only Phone Number ( ) Phone Number( ) Under penalties of perjury, I declare that I am an officer of the above corporation and that the information I have provided to my Electronic ReturnOriginator (ERO) and the amounts shown in Part I agree with the amounts shown on the corresponding lines of the corporation’s Iowa income taxreturn. To the best of my knowledge and belief the corporation’s return is true, correct, and complete. I consent that the corporation’s return, includingany accompanying schedules and statements, be sent to the Internal Revenue Service (IRS) by my ERO and retrieved by the Iowa Department ofRevenue (IDR). If the corporation is filing a balance due return, I understand that if the IDR does not receive full and timely payment of its tax liability,the corporation will remain liable for the tax liability and all applicable penalties and interest. I declare that the information shown in Part II is correct. Ifthere is an error on my federal return, I understand my state return may be rejected. If the processing of my return, refund, or direct debit is delayed, Iauthorize the IDR to disclose to my ERO and/or transmitter the reason(s) for the delay. I also consent to the IDR sending to my ERO and/or transmitteran acknowledgment of receipt of transmission and indication of whether or not my return is accepted, and, if rejected the reason(s) for the rejection. Iunderstand that this declaration with required attachments must be forwarded upon request to the IDR. Sign Here Signature of Officer Date Title a. Name of financial institution b. Routing number The first two digits must be 01 through 12 or 21 through 32. c. Account numberd. Type of account: Savings Checking e. Will this refund go to (or payment come from) an account outside the United States? Yes No 2012 IA 8453-C Instructions The IA 8453-C must be completed and then signed by an officer. Enter the name and Federal Employer Identification Number (FEIN) of the corporation at the top of the form. Complete Part I, Return Information, using amounts from the Iowa Corporation Income Tax Return. Part II – Declaration of Officer 1. Verify the accuracy of the tax return. 2. Ensure the following information related to the financial institution account is correct: • Routing number • Account number • Type of account (checking or savings) • Debit amount, if applicable • Debit date, if applicable 3. Read, sign and date the form. 4. Return the completed form to the ERO or paid preparer if using one. Note: The IA 8453-C should be retained for three years from the due date or filing date, whichever is later. Part III – Declaration of Electronic Return Originator (ERO) and Paid Preparer This section is completed only if the return is filed through an ERO or paid preparer. 1. Complete Part III, Declaration of ERO and Paid Preparer. 2. Provide the officer with a copy of the signed IA 8453-C or corrected IA 8453-C if changes are made. 3. Provide the officer with a signed copy of the tax return including all attachments. 4. Retain the signed IA 8453-C and all attachments for three years from the due date or filing date, whichever is later. File and Pay Electronically. Good for the environment. Good for you. DO NOT MAIL THE IA 8453-C. Retain with your records for at least three ye ars. 42-009b (08/17/12)
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