Iowa Individual Income Tax Declaration for E-File Return

2018 IA 8453-IND - Iowa Individual Income Tax Declaration for an e-File Return

https://tax.iowa.gov

Your first name, middle initial, and last name:

Your Social Security Number:

Spouse’s first name, middle initial, and last name:

Spouse’s Social Security Number:

Home address, city, state, ZIP:

Part I Tax Return Information

1. Iowa Net Income (IA 1040, line 26 A & B):

2. Total Tax (IA 1040, line 42 A & B):

3. Iowa Income Tax Withheld (IA 1040, line 63 A & B):

4. Amount to be Refunded (IA 1040, line 68):

5. Total Amount Due (IA 1040, line 73):

Part II Declaration of Taxpayer

6. I do not want direct deposit or direct debit.

7. I consent that my 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 my individual Iowa taxes owed on this return.

Payment/settlement date:

Name of financial institution:

Routing Number:

Account Number:

Type of Account: Savings Checking

Will this refund go to (or payment come from) an account outside the United States? Yes No

Under penalties of perjury, I declare that I have examined the information on my electronic individual income tax return and certify it is true, correct and complete.

Part III Declaration of Electronic Return Originator (ERO) and Paid Preparer

I declare that I have reviewed the taxpayer’s return and that entries on form IA 8453-IND are complete and correct to the best of my knowledge.

Check if also paid preparer Check if self-employed

Firm’s name (or yours if self-employed):

Address and zip code:

Check if self-employed

Firm’s name (or yours if self-employed):

Address and zip code:

2018 IA 8453-IND Instructions

The IA 8453-IND must be completed and signed before transmitting the return.

In lieu of an in-person handwritten signature otherwise required on Form IA 8453-IND, the Iowa Department of Revenue allows a paid preparer, at the discretion of the taxpayer, to collect the taxpayer’s electronic signature remotely by a process using identity verification and audit trail in the manner that the IRS allows for Form 8879.

Attach to the IA 8453-IND:

• State copies of W-2 forms

• A copy of other state tax return(s), if the IA 130 schedule was completed or the Iowa/Illinois reciprocal was claimed.

Enter the taxpayer name(s), Social Security Number(s), and address at the top of this form.

Part I – Tax Return Information: Complete using amounts from the Iowa Individual Income Tax Return.

Part II – Declaration of Taxpayer: Verify the return, ensure banking information is correct, sign and date the form, and retain copies for three years.

Part III – Declaration of Electronic Return Originator (ERO) and Paid Preparer: Complete only if filed through an ERO or paid preparer, provide copies to taxpayer, and retain forms for three years.

Do not submit the IA 8453-IND to the Iowa Department of Revenue unless requested to do so.