Delaware Individual Income Tax Declaration for Electronic Filing

Individual Income Tax Declaration for Electronic Filing
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IRS DECLARATION CONTROL NUMBER (DCN)

00-__ __ __ __ __ __-__ __ __ __ __- 1

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DELAWARE INDIVIDUAL INCOME TAX
DECLARATION FOR ELECTRONIC FILING

DE-8453

2010

FOR THE YEAR JANUARY 1 - DECEMBER 31, 2010
DO NOT MAIL!
YOUR SOCIAL SECURITY NUMBER

SPOUSE’S SOCIAL SECURITY NUMBER

FIRST NAME(S) AND INITIAL(S)

LAST NAME

S
T
A
T
E

HOME ADDRESS (NUMBER AND STREET INCLUDING RURAL ROUTE)
CITY, TOWN OR POST OFFICE, STATE & ZIP CODE
DAYTIME TELEPHONE NUMBER

PART 1
1.

TAX RETURN INFORMATION (WHOLE DOLLARS ONLY)

TOTAL DELAWARE ADJUSTED GROSS INCOME (FORM 200-01, LINE 1; FORM 200-02, LINE 37; FORM 200-03 EZ,
LINE 3)..................................................................................................................................................................................................

1.

2.

TOTAL DELAWARE TAX (FORM 200-01, LINE 8; FORM 200-02, LINE 42; FORM 200-03 EZ, LINE 8)..........................................

2.

3.

DELAWARE INCOME TAX WITHHELD (FORM 200-01, LINE 17; FORM 200-02, LINE 48; FORM 200-03 EZ, LINE 14)................

3.

4.

NET REFUND (FORM 200-01, LINE 27; FORM 200-02, LINE 58; FORM 200-03 EZ, LINE 23)........................................................

4.

5.

NET BALANCE DUE (FORM 200-01, LINE 26; FORM 200-02, LINE 57; FORM 200-03 EZ, LINE 22).............................................

5.

PART 2

Direct Deposit of Refund (Optional - See instructions.)

__ Checking __ Savings
7.
Routing number __ __ __ __ __ __ __ __ __
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

6.

Type of Account

8.

Account number

9.

Is this refund going to or through an account that is located outside of the United States?

PART 3
10.

O
F

Yes

No

DECLARATION OF TAXPAYER

__ I consent that my refund be directly deposited as designated in Part 2, and declare that the information shown on lines 6 through 9 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 or am not receiving a refund.
__ I authorize the Division of Revenue and its designated financial agent to initiate an electronic funds withdrawal (direct Debit) entry to the financial institution
account indicated in the tax preparation software for payment of my state taxes owed on this return.

If I have filed a balance due return, I understand that if the Delaware Division 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. If I have filed a joint Federal and State tax return and there is an error on my state return, I understand
my Delaware return will be rejected.
Under penalties of perjury, I declare that the information I have given my ERO and the amounts in Part 1 above agree with the amounts on the corresponding lines of
the electronic portion of my 2010 Delaware income tax return. To the best of my knowledge and belief, my return is true, correct, and complete. I consent to my ERO
sending my return, this declaration, and accompanying schedules and statements to the Delaware Division of Revenue. I also consent to the Delaware Division of
Revenue sending my ERO and/or transmitter an acknowledgment of receipt of transmission and an indication of whether or not my return is accepted, and, if rejected,
the reason(s) for the rejection. If the processing of my return or refund is delayed, I authorize the IRS to disclose to my ERO and/or transmitter the reason(s) for the
delay, or when the refund was sent.
SIGN
HERE
SIGNATURE

PART 4

DATE

SPOUSE’S SIGNATURE

DATE

DECLARATION OF ELECTRONIC RETURN ORIGINATOR (ERO) AND PAID PREPARER

I DECLARE THAT I HAVE REVIEWED THE ABOVE TAXPAYER’S RETURN AND THAT THE ENTRIES ON THIS FORM ARE COMPLETE AND CORRECT TO THE BEST OF MY KNOWLEDGE.
I HAVE OBTAINED THE TAXPAYER'S SIGNATURE ON FORM DE-8453 BEFORE SUBMITTING THIS RETURN TO THE INTERNAL REVENUE SERVICE (IRS) AND THE DELAWARE DIVISION
OF REVENUE (DDOR). I HAVE PROVIDED THE TAXPAYER WITH A COPY OF ALL FORMS AND INFORMATION TO BE FILED WITH THE IRS AND DDOR, AND HAVE FOLLOWED ALL
OTHER REQUIREMENTS DESCRIBED IN PUBLICATION DE-1345, HANDBOOK FOR ELECTRONIC FILERS OF INDIVIDUAL INCOME TAX RETURNS (TAX YEAR 2010) AND ANY
REQUIREMENTS SPECIFIED BY THE DELAWARE DIVISION 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. DECLARATION OF PREPARER IS BASED ON ALL INFORMATION OF WHICH PREPARER HAS ANY KNOWLEDGE.

SIGN
HERE
ERO

ERO’S SIGNATURE

DATE

FIRM’S NAME (OR YOURS IF SELF-EMPLOYED)

EIN, SSN, OR PTIN.

CHECK IF ALSO PREPARER

ADDRESS (STREET, CITY, STATE & ZIP CODE)

CHECK IF SELF-EMPLOYED

Business phone #

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.

SIGN
HERE
PAID
PREPARER

PREPARER’S SIGNATURE

FIRM’S NAME (OR YOURS IF SELF-EMPLOYED)

DATE

EIN, SSN, OR PTIN

CHECK IF SELF-EMPLOYED

ADDRESS (STREET, CITY, STATE & ZIP CODE)
(Revised 12/09/10)

D
E
L
A
W
A
R
E

Purpose of Form

-

Authenticate the electronic
portion of Form 200-01, 200-02,
or 200-03.

showing the routing number of the bank or
institution where the account is located. A
deposit slip should not be used because
it can contain internal routing numbers. If
there is any doubt about the correct
routing number the taxpayer should

-

Send any accompanying paper
schedules or statements.

the correct routing number for direct
deposit (Electronic Funds Transfers).

-

Authorize the electronic return
originator transmitter, and

-

Provide the taxpayer’s consent
to directly deposit any refund.

Note: Some financial institutions may not
accept direct deposits into accounts that
are payable through another bank or
financial institution, including credit unions.

Use Form DE-8453 to:

Line Instructions
IRS Declaration Control Number (DCN).
- The DCN is a 14-digit number assigned
by the ERO to each return. Clearly type
or print the DCN in the top left corner of
each Form 8453. Enter the number after
the IRS has acknowledged receipt of the
electronic return as follows:
Boxes

Entry
(always “00")
number (EFIN) assigned by the
IRS

9-11

Batch number (000-999)
assigned by the ERO

12-13

Serial number (00 to 99)
assigned by the ERO
2010, the year digit is “1”)

Example. The EFIN is 509325, The batch
number is 000. The serial number is 56.
The DCN is 00-509325-00056-8.
Name, Address, and Social Security
Number (SSN). Print or type the information
in the spaces provided. Please verify that
the SSN is clear and correct. If a joint return,
be sure the names and SSNs are listed in
the same order.
P.O. Box. - Enter the box number only if
taxpayer’s home.
Note: The address must match the
return.
Part 1 - Tax Return Information

Line 7. - The routing number must be
nine digits. If it does not begin with 01
through 12 or 21 through 32, the direct
deposit will be rejected and a check sent.
Line 8. - The account number can be up
to 17 characters (both numbers and
letters). Include hyphens but omit spaces
and special symbols. If fewer than 17
characters, enter the number from left to
right and leave the unused boxes blank.
Line 9. - In order to comply with new federal
banking rules, you must declare whether
your refund will go to a bank outside the
United States. If the answer is yes, do not
enter your account information. We will
instead mail your refund by check.
Caution: Some financial institutions do
not permit the deposit of a joint refund into
an individual account.
The Delaware
Division of Revenue is not responsible
when a financial institution refuses a
direct deposit.
Note: If the taxpayer wants the refund
directly deposited, be sure the
corresponding box for Line 10 in Part 3 is
checked.
Part 3 - Declaration of Taxpayer
An electronically transmitted return will not
be considered complete, and therefore
by the taxpayer is received by the IRS.
Line 10.

must check one of the boxes for

If the ERO makes changes to the
electronic return after Form DE-8453 has
been signed by the taxpayer but before it
is transmitted and either 1 or 2 below
applies, the ERO must have the taxpayer
complete and sign a corrected Form DE8453.
the amount on the electronic return by
more than $25, or

Line 5.- Do not include the payment with
Form DE- 8453. Instead, mail it by May
2, 2011, with
Form 200-V to the
applicable address shown on that form.

2. The total tax on line 2, the refund on
line 4, or the amount owed on line 5

Part 2 - Direct Deposit of Refund

Part 4 - Declaration of Electronic
Return Originator (ERO) and Paid
Preparer

Taxpayers who want to have their refund
directly deposited must complete Part 2.
A check, form, report, or other statement
should show the routing number and
account number.
institution other than the one at which the
account is located, the taxpayer should
use a document such as an account

return by more than $1.

A paid preparer must sign Form DE-8453
in the space for P aid Preparer’s Use
Only. Only handwritten signatures are
acceptable. But if the paid preparer is
also the ERO, do not complete the paid
preparer’s section. Instead, check the line
labeled “Check if also paid preparer.”
The IRS requires the ERO’s signature.
(Revised 11/22/10)