Form GA-8453 Fillable Form GA-8453 Individual Income Tax Declaration for Electronic Filing or 2D Barcode Direct Deposit (rev. 8/13)
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

ACH debit payment is available online at https://gaefile dor ga gov and through the payment option within tax software Credit card payments via Official Payment Corp (OPC) can be made either online at www officialpayment com or by phone by Mail a check with the 525 TV This voucher and other forms can be found online at www etax dor ga gov taxp ayer serv ices@do r ga gov Taxpayer Assistance 1 877 423 6711 7 8 41 Taxpayers filing from home computers must keep the signed GA 8453 and supporting documents for three (3) years after the A fraud hotline has been established for practitioners and taxpayers to report tax related activities that they believe are illegal or After the return has been prepared and before the return is transmitted the taxpayer (and spouse if joint) must verify the also be provided anonymous ATTACHMENTS: Attach copies of Forms W 2 and 1099 s and any schedules and/or documents with required signatures be kept for a period of 3 years from the end of the year for which the return is filed This is in accordance with Georgia Regulation 560 calling 1 800 2PAY TAX using jurisdiction code 2000 for Individual taxes due date of the return or the date the return was filled electronically whichever is later Enter either the DCN or Submission ID Enter the required data from the Georgia tax return Lines 1 3 must be completed Either line 4 or line 5 should also be completed For Rules and Regulations Frequently Asked Questions and forms please visit our website at www etax dor ga gov General Instructions Georgia Tax Center (GTC) http://www gataxinfo org/ If an ERO makes changes to the electronic return after the GA 8453 has been signed by the taxpayer but before transmittal the ERO incorrect The hotline can be used to report suspected illegal activity for all tax types Persons submitting reports may remain information on the return sign and date the completed GA 8453 The ERO must provide the taxpayer(s) with a copy of this instead check the box labeled Check if also paid preparer in the ERO section IRS DCN This is the IRS s Declaration Control Number This is a 14 digit number assigned to each return by the electronic returns KEEP THIS FORM FOR YOUR RECORDS LINE INSTRUCTIONS must have the taxpayer complete and sign a corrected GA 8453 NAME ADDRESS and PHONE NUMBER If the taxpayer received an address label and the information is correct that label may be of Revenue using one of the following methods: originator (ERO) This number will be the same as on the Federal return PART I TAX RETURN INFORMATION PART II DECLARATION OF CORPORATE OFFICER PART III DECLARATION OF ELECTRONIC RETURNS ORIGINATOR AND PAID PREPARER Payment of Balance Due It is the responsibility of the taxpayer who owes additional tax to make payment to the Georgia Department placed here Otherwise print or type the information in the space provided Any information that is not contained on the label should programs PURPOSE OF FORM Refunds 1 877 423 6711 REPORTING FRAUD 404 417 4266 or http://www dor ga gov/inctax/fraudreport html sign the GA 8453 in the space provided for the preparer If the preparer is also the ERO do not complete the Preparer Section; SUBMISSION ID This is a distinct number assigned to every return that is submitted This number can be used in tracking the return TAXPAYER COPY: The ERO must provide a copy of the completed GA 8453 and all other relevant and required information to the taxpayers TELEPHONE ASSISTANCE: The GA 8453 is a signature form summarizing the agreement between the taxpayer and ERO or paid preparer It may also be used by the Georgia Department of Revenue (GADOR) to authenticate the electronic portion of Form 500 or 500EZ This form is to be used The Georgia DOR requires that the ERO sign this form and keep it with the required attachments for three (3) years A preparer must These lines must reflect the amounts transmitted on the return when GA 500 or 500EZ is filed electronically or when a 2D barcode return is produced This form should not be mailed but should