Form
8879-EX
(Rev. December 2010)
Department of the Treasury
Internal Revenue Service
IRS e-file Signature Authorization
for Forms 720, 2290, and 8849
For the period beginning , 20 , and ending , 20
.
Do not send to the IRS. Keep for your records.
See instructions.
OMB No. 1545-2081
Name (as shown on Forms 720, 2290, or 8849) Taxpayer identification number
Part I Type of Return and Return Information (Whole dollars only)
Check the box for the return for which you are using this Form 8879-EX and enter the applicable amount from the return. If you check
the box on lines 1a, 2a, or 3a, below, and the amount on that line for the return for which you are filing this form was blank, leave lines
1b, 1c, 2b, or 3b, whichever is applicable, blank (do not enter -0-). However, if you entered -0- on the return, enter -0- on the
applicable line below. Do not complete more than one line in Part I.
1 a Form 720 check here
b Balance due, if any (Form 720, Part III, line 10) . . .
1b
c Overpayment, if any (Form 720, Part III, line 11) . . 1c
2 a Form 2290 check here
b Balance due (Form 2290, line 6) . . . . . . .
2b
3 a Form 8849 check here
b Total refund (from Schedules 1, 2, 3, 5, 6, or 8) . .
3b
Caution. For line 3b, Schedules 2, 3, 5, and 8 cannot be combined with any other schedules. File a separate Form 8879-EX
for each schedule.
Part II
Taxpayer Declaration and Signature Authorization
Under penalties of perjury, I declare that I have examined a copy of my electronic return and accompanying schedules and statements for the
period shown above and to the best of my knowledge and belief, they are true, correct, and complete. I further declare that the amounts in
Part I above are the amounts shown on the copy of my electronic return. I consent to allow my electronic return originator (ERO), transmitter,
or intermediate service provider to send my return to the IRS and to receive from the IRS (a) an acknowledgement of receipt or reason for
rejection of the transmission, (b) the reason for any delay in processing the return or refund, and (c) the date of any refund, that are required
for electronic returns processing. If applicable, 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 on this return, 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 two business days before 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. I have selected a personal identification number (PIN) as my signature for the electronic return and, if
applicable, my consent to electronic funds withdrawal.
Taxpayer’s PIN: check one box only
I authorize
ERO firm name
to enter my PIN
do not enter all zeros
as my signature
on my electronically filed return and, if filing Form 2290, the Consent to Disclosure of Tax Information.
I will enter my PIN as my signature on my electronically filed tax return or request for refund. Check this box
only if you are entering your own PIN and your return or request is filed using the Practitioner PIN method. The
ERO must complete Part III below.
Taxpayer’s signature
Date
Part III Certification and Authentication
ERO’s EFIN/PIN. Enter your six-digit EFIN followed by your five-digit self-selected PIN.
do not enter all zeros
I certify that the above numeric entry is my PIN, which is my signature on the electronically filed return for the taxpayer indicated
above. I confirm that I am submitting this return in accordance with the requirements of 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.
ERO’s signature
Date
ERO Must Retain This Form — See Instructions
Do Not Submit This Form to the IRS Unless Requested To Do So
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 49632M
Form 8879-EX (Rev. 12-2010)
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Form 8879-EX (Rev. 12-2010)
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Purpose of Form
Use Form 8879-EX if you and the electronic return originator
(ERO) want to use a personal identification number (PIN) to
electronically sign an electronic excise tax return or request for
refund.
If applicable, Form 8879-EX is also used to authorize an
electronic funds withdrawal. If you do not use Form 8879-EX to
sign your return, you must use Form 8453-EX, Excise Tax
Declaration, for an IRS e-file Return. For more information, see
the instructions for Form 8453-EX.
Do not send this form to the IRS. The ERO must retain
Form 8879-EX.
ERO Responsibilities
The ERO will:
• Enter the name and taxpayer identification number as shown
on Forms 720, 2290, or 8849.
• Complete Part I by checking the box for the type of return
being filed and using the amounts (zeros may be entered when
appropriate) from the return being filed.
• Enter on the authorization line in Part II the ERO firm name
(not the name of the individual preparing the return) if the ERO
is authorized to enter the taxpayer’s PIN.
• Give the taxpayer Form 8879-EX for completion and review.
This can be done by hand delivery, U.S. mail, private delivery
service, email, or Internet website.
• Complete Part III, including a signature and date.
!
CAUTION
Form 8879-EX must be completed and signed
before the electronic return is transmitted (or
released for transmission).
Taxpayer’s Responsibilities
The taxpayer filing Forms 720, 2290, or 8849 has the following
responsibilities.
• Verify the type of return being filed in Part I.
• Verify the accuracy of the prepared return.
• Check the appropriate box in Part II to either authorize the
ERO to enter your PIN or to choose to enter it in person.
• Indicate or verify his or her PIN when authorizing the ERO to
enter it (the PIN must be five numbers other than all zeros).
• Sign and date Part II.
• Return the completed Form 8879-EX to the ERO by hand
delivery, U.S. mail, private delivery service, or fax.
Note. Your return will not be transmitted to the IRS until the
ERO receives the signed Form 8879-EX.
Important Notes for EROs
• Do not send Form 8879-EX to the IRS unless requested to do
so. Retain the completed Form 8879-EX for 3 years from the
return due date or IRS received date, whichever is later.
• Enter the taxpayer’s PIN on the input screen only if the
taxpayer has authorized you to do so.
• Provide the taxpayer with a copy of the signed Form 8879-EX
upon request.
• Provide the taxpayer with a corrected copy of Form 8879-EX if
changes are made to the return (for example, based on the
taxpayer’s review).
• See Pub. 4163, Modernized e-File (MeF) Information for
Authorized IRS e-file Providers for Business Returns.
Paperwork Reduction Act Notice. We ask for the information
on this form to carry out the Internal Revenue laws of the United
States. You are required to give us the information. We need it
to ensure that you are complying with these laws and to allow
us to figure and collect the right amount of tax.
You are 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 this form will vary depending
on individual circumstances. The estimated average time is:
Recordkeeping . . . . . . . . . . . . 52 min.
Learning about the law
or the form . . . . . . . . . . . . . . . 6 min.
Preparing, copying, assembling,
and sending the form . . . . . . . . . . . 9 min.
If you have comments concerning the accuracy of these time
estimates or suggestions for making this form simpler, we would
be happy to hear from you. You can write to the Internal
Revenue Service, Tax Products Coordinating Committee,
SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, IR-6526,
Washington, DC 20224. Do not send Form 8879-EX to this
address. Instead, keep it for your records.