Form 8453-EMP
(Rev. February 2017)
Department of the Treasury
Internal Revenue Service
Employment Tax Declaration for an IRS e-file Return
For the period beginning , 20 , and ending , 20
.
For use with Forms 940, 940-PR, 941, 941-PR, 941-SS, 943, 943-PR, 944, and 945.
File electronically. Don't file paper copies.
Information about Form 8453-EMP and its instructions is at www.irs.gov/form8453emp.
OMB No. 1545-0967
Name (as shown on Form 940, 940-PR, 941, 941-PR, 941-SS, 943, 943-PR, 944, or 945) Employer identification number
Part I
Type of Return and Return Information (Whole dollars only)
Check the box for the return that you'll file using this Form 8453-EMP. Enter the amounts from the applicable lines of the return. If any of the
applicable lines on the return are blank, leave line 1b, 1c, 2b, 2c, 3b, 3c, 4b, 4c, 5b, or 5c, whichever is applicable, blank (don't enter -0-).
However, if you entered -0- on the return, enter -0- on the applicable line. Complete a separate Form 8453-EMP for each return.
1a Form 940 check here
(all 940 series)
b. Total payments to all employees (Form 940, Part 2, line 3) 1b
c. Balance due (Form 940, Part 4, line 14) . . . . . . . 1c
2a Form 941 check here
(all 941 series)
b. Total taxes after adjustments and credits (Form 941, Part
1, line 12) . . . . . . . . . . . . . . . . .
2b
c. Balance due (Form 941, Part 1, line 14) . . . . . . . 2c
3a Form 943 check here
(all 943 series)
b. Total wages subject to social security tax (Form 943,
line 2) . . . . . . . . . . . . . . . . . .
3b
c. Balance due (Form 943, line 15) . . . . . . . . . 3c
4a Form 944 check here
b. Wages, tips, and other compensation (Form 944, Part 1,
line 1) . . . . . . . . . . . . . . . . . .
4b
c. Balance due (Form 944, Part 1, line 11) . . . . . . . 4c
5a Form 945 check here
b. Total taxes (Form 945, line 3) . . . . . . . . . . 5b
c. Balance due (Form 945, line 5) . . . . . . . . . . 5c
Part II
Declaration of Taxpayer (see instructions)
6a I'm requesting a refund on Form 940, 940-PR, 941, 941-PR, 941-SS, 943, 943-PR, 944, or 945.
b
I authorize the U.S. Treasury 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 the federal taxes owed for the
return indicated on lines 1a, 2a, 3a, 4a, or 5a, and the financial institution to debit the entry to this account. To revoke a
payment, I must contact the U.S. Treasury Financial Agent at 1-888-353-4537 no later than 2 business days prior to the
payment (settlement) date. I also authorize the financial institutions 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.
Under penalties of perjury, I declare that I have an approved role (as identified in the instructions for the employment tax return) within the company listed above and the
information I've given the electronic return originator (ERO), transmitter, and/or intermediate service provider (ISP) and the amounts in Part I above agree with the amounts
on the corresponding return. To the best of my knowledge and belief, the return is true, correct, and complete. I consent to the ERO, transmitter, and/or ISP sending the
return, this declaration, and accompanying schedules and statements to the IRS. I also consent to the IRS sending the ERO, transmitter, and/or ISP an acknowledgment of
receipt of transmission and an indication of whether or not the return is accepted and, if rejected, the reason(s) for the rejection. If the processing of the return or refund is
delayed, I authorize the IRS to disclose to the ERO, transmitter, and/or ISP the reason(s) for the delay, or when the refund was sent.
Sign
Here
Taxpayer’s signature Print your name and title
Date
Part III
Declaration of Electronic Return Originator (ERO) and Paid Preparer (see instructions)
I declare that I've reviewed the return indicated above and that the entries on Form 8453-EMP are complete and correct to the best of my knowledge. If I'm only a collector,
I'm not responsible for reviewing the return and only declare that this form accurately reflects the data on the return. The taxpayer will have signed this form before I submit
the return. I'll give the taxpayer a copy of all forms and information to be filed with the IRS, and have followed all other requirements in Pub. 3112, IRS e-file Application and
Participation, and Pub. 4163, Modernized e-File (MeF) Information for Authorized IRS e-File Providers for Business Returns. If I'm also the paid preparer, under penalties of
perjury I declare that I've examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and
complete. This paid preparer declaration is based on all information of which I have any knowledge.
ERO’s
Use
Only
ERO’s
signature
Date Check if
also paid
preparer
Check if self-
employed
ERO’s SSN or PTIN
Firm’s name (or yours
if self-employed),
address, and ZIP code
EIN
Phone no.
Under penalties of perjury, I declare that I've examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is
true, correct, and complete. This declaration is based on all information of which I have any knowledge.
Paid
Preparer
Use Only
Print/Type preparer’s name Preparer’s signature Date
Check if self-
employed
PTIN
Firm’s name
Firm’s address
Firm’s EIN
Phone no.
For Privacy Act and Paperwork Reduction Act Notice, see instructions.
Cat. No. 62873J
Form 8453-EMP (Rev. 2-2017)
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Form 8453-EMP (Rev. 2-2017)
Page 2
Future Developments
For the latest information about developments related to Form
8453-EMP and its instructions, such as legislation enacted after
they were published, go to www.irs.gov/form8453emp.
General Instructions
Note: Instead of filing Form 8453-EMP, a taxpayer filing an
employment tax return through an electronic return originator (ERO)
can sign the return using a personal identification number (PIN).
For details, see Form 8879-EMP, IRS e-file Signature Authorization
for Forms 940, 940-PR, 941, 941-PR, 941-SS, 943, 943-PR, 944,
and 945.
Purpose of Form
Use Form 8453-EMP to:
• Authenticate an electronic Form 940, 940-PR, 941, 941-PR,
941-SS, 943, 943-PR, 944, or 945;
• Authorize the ERO, if any, to transmit via a third-party transmitter;
• Authorize the intermediate service provider (ISP) to transmit via a
third-party transmitter if you're filing online (not using an ERO); and
• Provide the taxpayer’s consent to authorize an electronic funds
withdrawal for payment of federal taxes owed.
Who Must File
If you're filing Form 940, 940-PR, 941, 941-PR, 941-SS, 943,
943-PR, 944, or 945 through an ISP and/or transmitter and you're
not using an ERO, you must file Form 8453-EMP with the
electronically filed return. An ERO can use either Form 8453-EMP or
Form 8879-EMP to obtain authorization to file Form 940, 940-PR,
941, 941-PR, 941-SS, 943, 943-PR, 944, or 945.
When and Where To File
File Form 8453-EMP with the taxpayer’s electronically filed return.
Use a scanner to create a Portable Document Format (PDF) file of
the completed form. Your tax preparation software will allow you to
transmit this PDF with the return.
Specific Instructions
Name. Print or type the taxpayer’s name as shown on Form 940,
940-PR, 941, 941-PR, 941-SS, 943, 943-PR, 944, or 945.
Employer identification number (EIN). Enter the EIN as shown on
Form 940, 940-PR, 941, 941-PR, 941-SS, 943, 943-PR, 944, or 945.
Part II. Declaration of Taxpayer
If the taxpayer has a balance due on line 1c, 2c, 3c, 4c, or 5c and
the taxpayer didn't check box 6b, the taxpayer must use the
Electronic Federal Tax Payment System (EFTPS) to pay the tax. For
more information on deposits, see the instructions for the tax form
the taxpayer is filing.
If the taxpayer checks box 6b, the taxpayer must ensure that the
following information relating to the financial institution account is
provided in the tax preparation software.
• Routing number and account number.
• Type of account (checking or savings).
• Debit amount.
• Debit date (date the taxpayer wants the debit to occur).
An electronically transmitted return won't be considered
complete, and therefore filed, unless either:
• Form 8453-EMP is signed by the taxpayer, scanned into a PDF
file, and transmitted with the return; or
• The return is filed through an ERO and Form 8879-EMP is used to
select a PIN that is used to electronically sign the return.
The taxpayer’s signature allows the IRS to disclose to the ERO,
transmitter, and/or ISP:
• An acknowledgement that the IRS has accepted the electronically
filed return, and
• The reason(s) for any delay in processing the return or refund.
Part III. Declaration of Electronic Return
Originator (ERO) and Paid Preparer
Note: If the return is filed online through an ISP and/or transmitter
(not using an ERO), don't complete Part III.
If the taxpayer’s return is filed through an ERO, the IRS requires
the ERO’s signature. A paid preparer, if any, must sign Form
8453-EMP in the space for Paid Preparer Use Only. But if the paid
preparer is also the ERO, don't complete the paid preparer section.
Instead, check the box labeled “Check if also paid preparer.”
Refunds. After the IRS has accepted the return, the refund should
be issued within 3 weeks. However, some refunds may be delayed
to ensure that returns are accurate.
Use of PTIN
Paid preparers. Anyone who is paid to prepare the taxpayer's
return must enter their preparer tax identification number (PTIN) in
Part III. The PTIN entered must have been issued after September
27, 2010. For information on applying for and receiving a PTIN, see
Form W-12 or visit www.irs.gov/ptin.
EROs who aren't paid preparers. Only EROs who aren't also the
paid preparer of the return have the option to enter their PTIN or
their social security number in the “ERO's Use Only” section of Part
III. If the PTIN is entered, it must have been issued after September
27, 2010. For information on applying for and receiving a PTIN, see
Form W-12 or visit www.irs.gov/ptin.
Privacy Act and Paperwork Reduction Act Notice. We ask for the
information on Form 8453-EMP to carry out the Internal Revenue
laws of the United States. You're required to give us the
information. We need it to ensure that you're complying with these
laws and to allow us to figure and collect the right amount of tax.
Section 6109 requires EROs to provide their identifying numbers on
the return.
You're not required to provide the information requested on a
form that is subject to the Paperwork Reduction Act unless the form
displays a valid OMB control number. Books or records relating to a
form or its instructions must be retained as long as their contents
may become material in the administration of any Internal Revenue
law. Generally, tax returns and return information are confidential,
as required by Internal Revenue Code section 6103.
The time needed to complete and file this form will vary
depending on individual circumstances. The estimated average time
is:
Recordkeeping . . . . . . . . . . . . 2 hr., 9 min.
Learning about the law or the form . . . . . . . 6 min.
Preparing, copying, assembling, and sending
the form to the IRS . . . . . . . . . . . . . 8 min.
If you have comments concerning the accuracy of these time
estimates or suggestions for making Form 8453-EMP simpler, we
would be happy to hear from you. You can send us comments from
www.irs.gov/formspubs. Click on More Information and then click
on Give us feedback. Or you can send your comments to Internal
Revenue Service, Tax Forms and Publications Division, 1111
Constitution Ave. NW, IR-6526, Washington, DC 20224. Don't send
Form 8453-EMP to this address. Instead, see When and Where To
File on this page.
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