8879-WH E-file Authorization for Form 1042

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Form

8879-WH

E-file Authorization for Form 1042
For calendar year 20

(Rev. December 2022)
Department of the Treasury
Internal Revenue Service

OMB No. 1545-0967

2022

Do not send to the IRS. Keep for your records.
Go to www.irs.gov/Form8879WH for the latest information.

Employer identification number

Name of withholding agent

DRAFT AS OF
October 14, 2022
DO NOT FILE

Part I
1

Tax Return Information (Whole dollars only)
Total gross amounts reported (Form 1042, line 62c) .

Part II

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1

Declaration and Signature Authorization of Withholding Agent. Be sure to get a copy of the Form 1042.

Under penalties of perjury, I declare that I have an approved role (as identified in the Instructions for Form 1042) with the withholding
agent listed above and that I have examined a copy of the electronic return and accompanying schedules and statements and to the
best of my knowledge and belief, it is 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 electronic return originator (ERO), transmitter, or intermediate
service provider 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. 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 balance due on Form 1042, 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 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 return and, if applicable, the
consent to electronic funds withdrawal.
Withholding Agent’s PIN: check one box only
I authorize

to enter my PIN
ERO firm name

as my signature
do not enter all zeros

on the electronically filed return.
I will enter my PIN as my signature on the electronically filed return.

Your signature

Part III

Date

Capacity in which acting

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 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. 92861F

Form 8879-WH (Rev. 12-2022)

Page 2

Form 8879-WH (Rev. 12-2022)

Future Developments
For the latest information about
developments related to Form 8879-WH
and its instructions, such as legislation
enacted after they were published, visit
www.irs.gov/Form8879WH.

Withholding Agent
Responsibilities
The withholding agent will:
• Verify the accuracy of the return;

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.

DRAFT AS OF
October 14, 2022
DO NOT FILE

Purpose of Form

A withholding agent and an electronic
return originator (ERO) use Form
8879-WH when the withholding agent
wants to use a personal identification
number (PIN) to electronically sign a
return and, if applicable, consent to
electronic funds withdrawal. A
withholding agent who does not use
Form 8879-WH must use Form
8453-WH, E-file Declaration for Form
1042. For more information, see the
instructions for Form 8453-WH.

• Check the appropriate box in Part II to
either authorize the ERO to enter the
PIN or to choose to enter it in person;
• Indicate or verify the PIN when
authorizing the ERO to enter it (the PIN
must be five digits other than all zeros);
• Sign, date, and enter the capacity in
which you are acting in Part II; and

• Return the completed Form 8879-WH
to the ERO. The acceptable delivery
methods include hand delivery, U.S.
mail, private delivery service, email,
Internet website, and fax.

Do not send this form to the IRS.
The ERO must retain Form 8879-WH.

The return will not be transmitted to
the IRS until the ERO receives the signed
Form 8879-WH.

ERO Responsibilities

Important Notes for EROs

The ERO will:

• Do not send Form 8879-WH to the IRS
unless requested to do so. Retain the
completed Form 8879-WH for 3 years
from the return due date or IRS received
date, whichever is later. Form 8879-WH
can be retained electronically in
accordance with the recordkeeping
guidelines in Rev. Proc. 97-22, which is
on page 9 of Internal Revenue Bulletin
1997-13 at www.irs.gov/pub/irs-irbs/
irb97-13.pdf.

• Enter the name and employer
identification number of the withholding
agent at the top of the form;
• Complete Part I using the amounts
from Form 1042, line 62c;
• 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
withholding agent’s PIN;
• Give the withholding agent Form
8879-WH for completion and review
(acceptable delivery methods include
hand delivery, U.S. mail, private delivery
service, email, Internet website, and fax);
and
• Complete Part III including a signature
and date.
You must receive the
completed and signed Form
8879-WH from the withholding
CAUTION agent before the electronic
return is transmitted (or released for
transmission).

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• Enter the withholding agent’s PIN on
the input screen only if the withholding
agent has authorized you to do so.
• Provide the withholding agent with a
copy of the signed Form 8879-WH upon
request.
• Provide the withholding agent with a
corrected copy of Form 8879-WH if
changes are made to the return (for
example, based on the withholding
agent’s review).
• See Pub. 4163, Modernized e-File
(MeF) Information for Authorized IRS
e-file Providers for Business Returns, for
more information.

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 and file
this form will vary depending on
individual circumstances. The estimated
burden for withholding agents filing this
form is approved under OMB control
number 1545-0967 and is included in the
estimates shown in the instructions for
their return.
Comments. You can send us comments
through www.irs.gov/FormComments.
You can also send your comments to the
Internal Revenue Service, Tax Forms and
Publications Division, 1111 Constitution
Ave. NW, IR-6526, Washington, DC
20224. Do not send the form to this
address. Instead, keep it for your
records.