8453-TE Tax Exempt Entity Declaration and Signature for Electron

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Form

8453-TE

Tax Exempt Entity Declaration and Signature
for Electronic Filing
For calendar year 2021, or tax year beginning

, 2021, and ending

OMB No. 1545-0047

2021

, 20

Department of the Treasury For use with Forms 990, 990-EZ, 990-PF, 990-T, 1120-POL, 4720, 8868, 5227, 5330, and 8038-CP
▶ Go to www.irs.gov/Form8453TE for the latest information.
Internal Revenue Service
EIN or SSN

Name of filer

Part I

DRAFT AS OF
October 28, 2021
DO NOT FILE
Type of Return and Return Information

Check the box for the type of return being filed with Form 8453-TE and enter the applicable amount, if any, from the return. Form 8038-CP
and Form 5330 filers may enter dollars and cents. For all other forms, enter whole dollars only. If you check the box on line 1a, 2a, 3a, 4a, 5a,
6a, 7a, 8a, 9a, or 10a below, and the amount on that line of the return being filed with this form was blank, then leave line 1b, 2b, 3b, 4b, 5b,
6b, 7b, 8b, 9b, or 10b, whichever is applicable, blank (do not enter -0-). If you entered -0- on the return, then enter -0- on the applicable line
below. Do not complete more than one line in Part I.
1b
b Total revenue, if any (Form 990, Part VIII, column (A), line 12) . .
1a Form 990 check here . . ▶
2b
2a Form 990-EZ check here . ▶
b Total revenue, if any (Form 990-EZ, line 9) . . . . . . . .
3b
3a Form 1120-POL check here ▶
b Total tax (Form 1120-POL, line 22) . . . . . . . . . .
4b
4a Form 990-PF check here . ▶
b Tax based on investment income (Form 990-PF, Part VI, line 5) .
5b
5a Form 8868 check here . . ▶
b Balance due (Form 8868, line 3c) . . . . . . . . . . .
6b
6a Form 990-T check here . ▶
b Total tax (Form 990-T, Part III, line 4) . . . . . . . . . .
7b
7a Form 4720 check here . . ▶
b Total tax (Form 4720, Part III, line 1) . . . . . . . . . .
8b
8a Form 5227 check here . . ▶
b FMV of assets at end of tax year (Form 5227, Item D) . . . .
9b
9a Form 5330 check here . . ▶
b Tax due (Form 5330, Part II, line 19) . . . . . . . . . .
10a Form 8038-CP check here ▶
b Amount of credit payment requested (Form 8038-CP, Part III, line 22) 10b

Part II

Declaration of Officer or Person Subject to Tax

11a

I authorize the U.S. Treasury and its designated Financial Agent to initiate an Automated Clearing House (ACH) 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 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.

b

If a copy of this return is being filed with a state agency(ies) regulating charities as part of the IRS Fed/State program, I certify that I
executed the electronic disclosure consent contained within this return allowing disclosure by the IRS of this Form 990/990-EZ/
990-PF (as specifically identified in Part I above) to the selected state agency(ies).

Under penalties of perjury, I declare that
I am an officer of the above named entity or
I am the person subject to tax with respect to
(name of entity)
, (EIN)
,
and that I have examined a copy of the 2021 electronic return and accompanying schedules and statements, and, to the best of my
knowledge and belief, they are true, correct, and complete. I further declare that the amount in Part I above is the amount shown on the copy
of the electronic return. I consent to allow my intermediate service provider, transmitter, or electronic return originator (ERO) to send the 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.

Part III

Signature of officer or person subject to tax

Date

▲

▲

Sign
Here

Title, if applicable

Declaration of Electronic Return Originator (ERO) and Paid Preparer (see instructions)

I declare that I have reviewed the above return and that the entries on Form 8453-TE 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 entity officer or person subject to tax will have signed this form before I submit the return. I will give a copy of all forms and information to
be filed with the IRS to the officer or person subject to tax, and have followed all other requirements in Pub. 4163, Modernized e-File (MeF)
Information for Authorized IRS e-file Providers for Business Returns. If I am also the Paid Preparer, under penalties of perjury I declare that I
have examined the above return and accompanying schedules and statements, and, to the best of my knowledge and belief, they are true,
correct, and complete. This Paid Preparer declaration is based on all information of which I have any knowledge.
Date

▲

ERO’s
signature
Firm’s name (or yours if
self-employed),
address, and ZIP code

Check if also
paid preparer

Check if selfemployed

▲

ERO’s
Use
Only

ERO’s SSN or PTIN

EIN
Phone no.

Under penalties of perjury, I declare that I have examined the above 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.

Paid
Preparer
Use Only

Print/Type preparer’s name

Preparer’s signature

Date

PTIN

Firm’s EIN ▶

Firm’s name ▶
Firm’s address

Check if selfemployed

Phone no.

▶

For Privacy Act and Paperwork Reduction Act Notice, see back of form.

Cat. No. 31574T

Form 8453-TE (2021)

Page 2

Form 8453-TE (2021)

Instead of filing Form 8453-TE, an entity officer or person
subject to tax filing an exempt entity return through an
electronic return originator (ERO) can sign the return
using a personal identification number (PIN). For details,
see Form 8879-TE, IRS e-file Signature Authorization for a Tax
Exempt Entity.

Form 5330. File Form 5330 to report excise taxes in accordance the
with the Instructions for Form 5330 for the applicable due dates. The
Form 8453-TE must be filed with the electronically filed Form 5330.

Future Developments

How To File

For the latest information about developments related to Form
8453-TE and its instructions, such as legislation enacted after they
were published, go to www.irs.gov/Form8453TE.

File Form 8453-TE with the electronically filed return. Use a scanner
to create a PDF file of the completed form. Your tax preparation
software will allow you to transmit this PDF file with the return.

Purpose of Form

Part II. Declaration of Officer or Person Subject to Tax

Use Form 8453-TE to:

If a Form 990-PF, Form 990-T, Form 1120-POL, Form 4720, Form
5330, or Form 8868 filer chooses to pay the tax due by electronic
funds withdrawal (direct debit), check the box. Otherwise, leave the
box blank.

TIP

Form 8038-CP. See the Instructions for Form 8038-CP for
information on when to file Form 8038-CP. The Form 8453-TE must
be filed with the electronically filed Form 8038-CP.

DRAFT AS OF
October 28, 2021
DO NOT FILE

• Authenticate the electronic Form 990, Return of Organization
Exempt From Income Tax; Form 990-EZ, Short Form Return of
Organization Exempt From Income Tax; Form 990-PF, Return of
Private Foundation; Form 990-T, Exempt Organization Business
Income Tax Return; Form 1120-POL, U.S. Income Tax Return for
Certain Political Organizations; Form 4720, Return of Certain Excise
Taxes Under Chapters 41 and 42 of the Internal Revenue Code;
Form 8868, Application for Automatic Extension of Time To File an
Exempt Organization Return; Form 5227, Split-Interest Trust
Information Return; Form 5330, Return of Excise Taxes Related to
Employee Benefit Plans; and Form 8038-CP, Return for Credit
Payments to Issuers of Qualified Bonds;
• 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
• Authorize an electronic funds withdrawal for payment of federal
taxes owed (Form 990-PF, Form 990-T, Form 1120-POL, Form
4720, Form 5330, or Form 8868 with payment).

Who Must File
If you’re filing a 2021 Form 990, Form 990-EZ, Form 990-PF, Form
990-T, Form 1120-POL, Form 4720, Form 5330, or Form 8868 with
payment through an ISP and/or transmitter and you’re not using an
ERO, you must file Form 8453-TE with your electronically filed
return. An ERO can use either Form 8453-TE or Form 8879-TE to
obtain authorization to file a Form 990, Form 990-EZ, Form 990-PF,
Form 990-T, Form 4720, Form 1120-POL, or to file a Form 8868
with payment.

When To File
Form 990, Form 990-EZ, Form 990-PF, or Form 990-T. File Form
990, Form 990-EZ, or Form 990-PF by the 15th day of the 5th month
after the organization’s accounting period ends. For information on
when to file Form 990-T, see the Instructions for Form 990-T. If the
regular due date falls on a Saturday, Sunday, or legal holiday, the
organization may file on the next business day. The Form 8453-TE
must be filed with the electronically filed Form 990, Form 990-EZ,
Form 990-PF, or Form 990-T.
Form 1120-POL. File Form 1120-POL by the
day of the
month after the organization’s accounting period ends. If the regular
due date falls on a Saturday, Sunday, or legal holiday, the
organization may file on the next business day. The Form 8453-TE
must be filed with the electronically filed Form 1120-POL.
15th

4th

Form 4720. Generally, file Form 4720 by the due date of the
organization’s Form 990, 990-EZ, 990-PF, 990-T, or Form 5227,
Split Interest Trust Information Return. If none of these forms is
required, file Form 4720 by the 15th day of the 5th month after the
end of the tax year. The Form 8453-TE must be filed with the
electronically filed Form 4720.
Form 8868. Generally, file Form 8868 by the due date of the return
for which you’re requesting an extension. The Form 8453-TE must
be filed with the electronically filed Form 8868.
Form 5227. File Form 5227 for a calendar year by April 15 of the
following year. In the case of a final short-year period, the return is
due by the 15th day of the 4th month following the date of the trust’s
termination. The Form 8453-TE must be filed with the electronically
filed Form 5227.

If the officer or person subject to tax checks the box when filing
Form 990-PF, Form 990-T, Form 1120-POL, Form 4720, Form
5330, or Form 8868 with payment, that person must ensure that the
following information relating to the financial institution account is
provided in the tax preparation software.
• Routing number,

• Account number,

• Type of account (checking or savings),
• Debit amount, and

• Debit date (date the entity or person subject to tax wants the debit
to occur).
In the third paragraph, check the appropriate box to declare
whether you are an officer or person subject to tax (and enter the
name of the entity and employer identification number (EIN)).
An electronically transmitted return will not be considered
complete (and therefore not considered filed) unless either:
• Form 8453-TE is signed by an officer or person subject to tax,
scanned into a PDF file, and transmitted with the return; or
• The return is filed through an ERO and Form 8879-TE is used to
select a PIN that is used to electronically sign the return.
The signature of the officer or person subject to tax allows the IRS
to disclose to the ISP, ERO, and/or transmitter:
• An acknowledgment that the IRS has accepted the electronically
filed return, and
• The reason(s) for a delay in processing the return or refund.
The declaration of officer or person subject to tax must be signed
and dated by:
• The president, vice president, treasurer, assistant treasurer, chief
accounting officer; or
• Any other officer or person subject to tax authorized to sign the
return.
If this return contains instructions to the IRS to provide a copy(ies)
of the return to a state agency(ies) regulating charities as part of the
IRS Fed/State program, the checkbox in Part II must be checked.

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 the ERO’s Use Only section in
Part III.
If the return is filed through an ERO, the IRS requires the ERO’s
signature. A paid preparer, if any, must sign Form 8453-TE in the
space for Paid Preparer Use Only. But if the paid preparer is also
the ERO, don’t complete the paid preparer’s section. Instead, check
the box labeled Check if also paid preparer.
An ERO may sign the Form 8453-TE by rubber stamp, mechanical
device, or computer software program. The alternative method of
signing must include either a facsimile of the individual ERO’s
signature or of the ERO’s printed name.

Page 3

Form 8453-TE (2021)

Use of PTIN
Paid preparers. Anyone who is paid to prepare the entity return
must enter their 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, IRS Paid Preparer Tax
Identification Number (PTIN) Application and Renewal, or visit
www.irs.gov/PTIN.

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. However,
certain returns and return information of tax exempt organizations
and trusts are subject to public disclosure and inspection, as
provided by section 6104.

DRAFT AS OF
October 28, 2021
DO NOT FILE

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 this form 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.

The time needed to complete and file this form will vary
depending on individual circumstances. The estimated burden for
tax exempt organizations filing this form is approved under OMB
control number 1545-0047 and is included in the estimates shown
in the instructions for their information return.