Form 8453 U.S. Individual Income Tax Declaration for an IRS e-file

U.S. Individual Income Tax Return

f8453--2019-00-00

U.S. Individual Income Tax Return

OMB: 1545-0074

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Form

8453

U.S. Individual Income Tax Transmittal for an IRS e-file Return

OMB No. 1545-0074

For the year January 1–December 31, 2019
▶ See instructions on back.
▶ Go to www.irs.gov/Form8453 for the latest information.

2019

Department of the Treasury
Internal Revenue Service

Your first name and initial

Please
print or
type.

P
R
I
N
T

Your social security number

Last name

DRAFT AS OF
July 9, 2019
DO NOT FILE
C
L
E
A
R
L
Y

If a joint return, spouse’s first name and initial

Spouse’s social security number

Last name

Home address (number and street). If you have a P.O. box, see instructions.

Apt. no.

▲

City, town or post office, state, and ZIP code (If a foreign address, also complete spaces below.)
Foreign country name

Foreign province/state/county

Important!
You must enter
your SSN(s) above.

▲

Foreign postal code

FILE THIS FORM ONLY IF YOU ARE ATTACHING ONE OR MORE
OF THE FOLLOWING FORMS OR SUPPORTING DOCUMENTS.

Check the applicable box(es) to identify the attachments.

Form 1098-C, Contributions of Motor Vehicles, Boats, and Airplanes (or equivalent contemporaneous written
acknowledgement)
Form 2848, Power of Attorney and Declaration of Representative (or POA that states the agent is granted authority to sign the
return)
Form 3115, Application for Change in Accounting Method

Form 3468 - attach a copy of the first page of NPS Form 10-168, Historic Preservation Certification Application (Part 2—
Description of Rehabilitation), with an indication that it was received by the Department of the Interior or the State Historic
Preservation Officer, together with proof that the building is a certified historic structure (or that such status has been
requested)
Form 5713, International Boycott Report
Form 8283, Noncash Charitable Contributions, Section A (if any statement or qualified appraisal is required), or Section B,
Donated Property, and any related attachments (including any qualified appraisal or partnership Form 8283)
Form 8332, Release/Revocation of Release of Claim to Exemption for Child by Custodial Parent (or certain pages from a
divorce decree or separation agreement that went into effect after 1984 and before 2009) (see instructions)
Form 8858, Information Return of U.S. Persons With Respect to Foreign Disregarded Entities (FDEs) and Foreign Branches (FBs)
Form 8885, Health Coverage Tax Credit, and all required attachments
Form 8949, Sales and Other Dispositions of Capital Assets (or a statement with the same information), if you elect not to
report your transactions electronically on Form 8949
DON’T SIGN THIS FORM.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see your tax return instructions.

Cat. No. 62766T

Form 8453 (2019)

Page 2

Form 8453 (2019)

General Instructions
Future Developments
For the latest information about developments related to
Form 8453 and its instructions, such as legislation
enacted after they were published, go to
www.irs.gov/Form8453.

Social security number (SSN). Be sure to enter the
taxpayer’s SSN in the space provided on Form 8453. If a
joint tax return, list the SSNs in the same order as the first
names.

DRAFT AS OF
▲ July 9, 2019
DO NOT FILE

Purpose of Form

Use Form 8453 to send any required paper forms or
supporting documentation listed next to the checkboxes
on Form 8453 (don’t send Form(s) W-2, W-2G, or
1099-R).
Don’t attach any form or document that isn’t
shown on Form 8453 next to the checkboxes. If
you are required to mail in any documentation
CAUTION
not listed on Form 8453, you can’t file the tax
return electronically.
Note: Don’t mail a copy of an electronically filed Form
1040, 1040-SR, 1040-NR, 1040-PR, or 1040-SS to the
Internal Revenue Service (IRS).

!

When and Where To File

If you are an ERO, you must mail Form 8453 to the IRS
within 3 business days after receiving acknowledgement
that the IRS has accepted the electronically filed tax
return.
If you are filing your tax return using an online provider,
mail Form 8453 to the IRS within 3 business days after
you have received acknowledgement from your
intermediate service provider and/or transmitter that the
IRS has accepted your electronically filed tax return. If
you don’t receive an acknowledgement, you must contact
your intermediate service provider and/or transmitter.
Mail Form 8453 to:
Internal Revenue Service
Attn: Shipping and Receiving, 0254
Receipt and Control Branch
Austin, TX 73344-0254

Specific Instructions
Name and address. Print or type the information in the
spaces provided. If using a foreign address, don’t
abbreviate the country name.
P.O. box. Enter the box number only if the post office
doesn’t deliver mail to the home address.
Note: The address must match the address shown on
the electronically filed tax return.

Payments

Don’t attach a payment to Form 8453. Instead, mail it by
April 15, 2020, with Form 1040-V to the IRS at the
applicable address shown on that form. If a Form 1040-V
isn’t available, see the instructions for your tax return for
other ways to get forms or you can go to
www.irs.gov/Forms.
To pay your taxes online or for more information, go to
www.irs.gov/Payments.
Form 2848. An electronically transmitted return signed by
an agent must have a power of attorney attached to Form
8453 that specifically authorizes the agent to sign the
return.
Divorce decree or separation agreement. If the divorce
decree or separation agreement went into effect after
1984 and before 2009, the noncustodial parent can
attach certain pages from the decree or agreement
instead of Form 8332. To be able to do this, the decree or
agreement must state all three of the following.
1. The noncustodial parent can claim the child as a
dependent without regard to any condition (such as
payment of support).
2. The other parent won’t claim the child as a
dependent.
3. The years for which the claim is released.
The noncustodial parent must attach all of the following
pages from the decree or agreement.
• Cover page (include the other parent’s SSN on that
page).
• The pages that include all of the information identified in
(1) through (3) above.
• Signature page with the other parent’s signature and
date of agreement.
Note: The noncustodial parent must attach the required
information even if it was filed with a return in an earlier
year.


File Typeapplication/pdf
File Title2019 Form 8453
SubjectFillable
AuthorSE:W:CAR:MP
File Modified2019-07-09
File Created2019-06-26

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