Section III Declaration of Fiduciary (Sign only after Section I is complete.)
10.
£
I consent for the refund from the 2020 PA-41, Fiduciary Income Tax Return, to be directly deposited as designated in Section 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.
£
The estate or trust is not receiving a refund or I do not want direct deposit of the refund.
£
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
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.
Under penalties of perjury, I declare that the amounts above match the amounts shown on the corresponding lines of the electronic portion of the 2020 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
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.
Signature of Fiduciary or Officer Date
Section 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.
➧
Sign
Here
ERO’s
Use
Only
Section II Direct Deposit of Refund or Electronic Funds Withdrawal of Tax Due (Optional – See instructions.)
6. Routing transit number (RTN)
7. Depositor account number (DAN)
8. Type of account:
£
Checking
£
Savings
9
.
Debit date
Declaration Control Number/Submission ID
Form PA-8453F
2020
PENNSYLVANIA FIDUCIARY INCOME TAX
DECLARATION FOR ELECTRONIC FILING
Name of Estate or Trust Employer Identification Number
Name and Title of Fiduciary
Address (Number and Street including Rural Route or P.O. Box)
City, Town or Post Office State ZIP Code
Section I Tax Return Information (Enter whole dollars only.)
1. Net PA taxable income (
Form PA-41, Line 9)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.
2. PA tax liability (Form PA-41, Line 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.
3. Total Payments and Credits (Form PA-41, Line 18) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.
4. Overpayment (Form PA-41, Line 23) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.
5. Total payment (tax due) (Form PA-41, Line 22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.
Print
or
Type
Please DO NOT mail this form.
The first two numbers of the RTN must
be 01 through 12 or 21 through 32.
➧
Check if also
paid preparer
£
Check if
self-employed £
Firm’s name (or yours,
if self-employed) and
address
➧
➧
➧
Paid
Preparer’s
Use Only
Check if
self-employed £
Firm’s name (or yours,
if self-employed) and
address
STAPLE COPY OF
STATE W-2(s), W-2G
and 1099(s) HERE
P
E
N
N
S
Y
L
V
A
N
I
A
PA DEPARTMENT OF REVENUE USE ONLY –
DO NOT WRITE OR STAPLE IN THIS SPACE
The above information must match that on the electronic return exactly.
a.
b.
c.
Preparer’s signature Date EIN/SSN or PTIN
Daytime Telephone Number ( )
Check if also
paid preparer £
For Calendar Year 2020, or Fiscal Year Beginning, , 2020 and Ending, , 20
(EX) 06-20
ERO’s signature Date EIN/SSN or PTIN
Daytime Telephone Number ( )
