Form GA-8453 — Individual Income Tax Declaration for E-filing

# PRINT CLEAR D

O N ERO MUST RETAIN THIS FORM.
O
E T
S

# DO NOT SUBMIT THIS FORM TO A M E A GEORGIA DEPARTMENT OF REVENUE L I

P L UNLESS REQUESTED TO DO SO.
!

IRSDCN OR SUBMISSION ID

# GEORGI A INDIVIDU AL INC OME TA X DECLARATI ON FOR ELECTRONIC FILING

SUMMARY OF AGREEMENT BETWEEN TAXPAYER AND ERO OR PAID PREPARER
Amended Return
First Name and Initial Last Name Social Security Number
I f J oint Return, Spouse' s Firs t N ame and Initial Spouse's Last Name Spouse's Social Security Number Home Address (number and street) Apt Number Daytime Telephone Number City, Town or Post Office State Zip Code

# PART I TAX RETURN INFORMATION

Federal Adjusted Gross Income (Form 500 , Line 8; Form 500EZ, Line 1) … 1.
Georgia Taxable Income (Form 500 , Line 15c; Form 500EZ, Line 3) … 2.
Net Georgia Tax (Form 500 , Line 23; Form 500EZ, Line 6) … 3.

4 . Balance Due (Form 500, Line 45; Form 500X, Line 38; Form 500EZ, Line 23) … 4.
5 . Refund (Form 500, Line 46; Form 500X, Line 39; Form 500EZ, Line 24) … 5.
PART II DECLARATION OF TAXPAYER(S)
Under penalties of perjury, I declare that the information I have provided to my Electronic Return Originator (ERO) and/or Online Service Provider and/or Transmitter and the amounts shown in Part I agree with the amounts shown on the corresponding lines of the electronic portion of my 2024 Georgia Income Tax Return. I declare that I have examined my tax return, including accompanying schedules and statements, and to the best of my knowledge and belief, my return is true, correct and complete. I consent that the electronic portion of my return may be sent by my ERO/Online Service Provider/Transmitter.

# SIGN HERE

TAXPAYER'S SIGNATURE Date SPOUSE'S SIGNATURE (if joint return, both must sig n) Date

EMAIL ADDRESS
PRINT NAME

# PART III DECLARATION OF ELECTRONIC RETURNS ORIGINATOR AND PAID PREPARER

I DECLARE THAT I HAVE REVIEWED THEABOVE TAXPAYER'S RETURNAND THAT THE ENTRIES ON THE GA-8453 ARE COMPLETE
AND CORRECT TO THE BEST OF MYKNOWLEDGE.
ERO's Signature _ Date _
ERO's
Firm's Name __ Check also if paid preparer
Use
Only
Address __ FEIN/PTIN
City, State, & Zip Code____ SSN/TIN
IF PREPARED BYANY PERSON OTHER THAN THE TAXPAYER, THIS DECLARATION IS BASED ONALL INFORMATION OFWHICH
THE PREPARER HASANYKNOWLEDGE.
Paid Preparer's Signature _ Date _
Paid
Firm's Name __ FID/TIN
Preparer's
Address __ SSN/TIN
Use Only
City, State, & Zip Code____
GA-8453 (REV 07/11/24)

# KEEP A COPY WITH YOUR RECORDS

# General Instructions

# PURPOSE OF FORM

The GA-8453 i s a signature form summarizing the agreement between the taxpayer an d ERO or paid preparer. It may also be used b y the Georgia Department of Revenue (GADOR) to authenticate the electronic portion of Form 500, 500 EZ or 500X. This form is to be used when GA 500, 500EZ or 500X is filed electronically. This form should not be mailed, but should be kept for a period of 3 years from the end of the year of which the return is filed. Taxpayers filing from home computers must keep the signed GA-8453 and supporting documents for three (3) years after the due date of the return or the date the return was filed electronically, whichever is later.

# LINE INSTRUCTIONS

Enter either the DCN or Submission ID.
IRS DCN - This is the IRS's Declaration Control Number. This is a 1 4 digit number assigned to each return b y the electronic returns originator (ERO). This number will b e the same as on the Federal return.
SUBMISSION ID - This is a distinct ID assigned to ever y electronic return that is submitted to Georgia. This 20 character ID can be used in trackin g the return.

# PART I - TA X INFORMATION

Enter the required data from the Georgia tax return. Line s 1- 3 must be completed. Eithe r Line 4 or Lin e 5 should als o be completed.
These lines must reflect t he amounts transmitted on the return.
Payment of Balance D ue - It is the responsibilit y of the taxpayer who owes additional tax to make payment to the Georgia Department of Revenue using one of the following methods:
Mail a check with the 525-TV. This voucher and other forms can be found online at dor.georgia.gov. ACH debit payment is available online at https://gtc.dor.ga.gov and through the payment option within tax software programs.
Credit card payments can be made online. For more information, see https://dor.georgia.gov/taxes/how-do-i-make-tax-payment.
PART II - DECLARATION OF TAXPAYER(S) fter the return has been prepared and before the return is transmitted, the taxpayer (and spouse, if j oint) must verify the nformatio n on the return, and sign and date the completed GA-8453. The ERO must provide the taxpayer(s) with a copy of this form.
If an ERO makes changes to the electronic return after t he GA-8453 has been signed by the taxpayer, but before transmittal, the ERO must have th e taxpayer complete and sign a corrected GA-8453.

# PART III - DECLARATION OF ELECTRONIC RETURNS ORIGINATOR AND PA ID PREPARER

The Georgia DOR requires that the ERO sig n this form an d keep i t with the required attachments for three (3 ) years. A preparer must sign the GA-8453 in the space provided for the preparer. If the preparer is also the ERO, do not complete the Preparer Section ; instead, check the box labele d "Check als o if paid preparer" i n the ERO section.
TAXPAYER(S)' COPY: The ERO must provide a co py of the completed GA-8453 and all other relevant and required information to the taxpayer(s).
TELEPHONE ASSISTANCE:
Refunds
Taxpayer Assistance
INDIVIDUAL TAX QUESTIONS:
Georgia Tax Center (GTC)

# REPORTING FRAUD

1-877-423-6711
1-877-423-6711 revenue.taxpayerservice@dor.ga.gov https://gtc.dor.ga.gov dor.georgia.gov/webform/fraud-referral-form A fraud hotline has been established for practitioners and taxpayers to report tax-related activities that they believe are illegal or incorrect. The hotline can be used to report suspected illegal activity for all tax types. Persons submitting reports may remain anonymous.
For Rules an d Regulations, Frequently Asked Question s and forms, please visit our website at dor.georgia.gov

# KEEP THIS FORM FOR YOUR RECORDS

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