State
Form   
8453 
Department of the Treasury  
Internal Revenue Service 
U.S. Individual Income Tax Transmittal for an IRS 
e-file 
Return
For the year January 1–December 31, 2013
a
 See instructions on back.
a
 
Information about Form 8453 and its instructions is available at 
www.irs.gov/form8453
.
OMB No. 1545-0074
20
13
Please 
print
 
or 
type. 
P 
R 
I 
N 
T 
 
C 
L 
E 
A 
R 
L 
Y
Your first name and initial 
Last name 
Your social security number 
If a joint return, spouse’s first name and initial 
Last name 
Spouse’s social security number 
c
Important! 
You 
must 
enter  
your SSN(s) above. 
c
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
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 4136 - attach the Certificate for Biodiesel and, if applicable, Statement of Biodiesel Reseller or a certificate from the
provider identifying the product as renewable diesel and, if applicable, a statement from the reseller
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
Form 8864 - attach the Certificate for Biodiesel and, if applicable, Statement of Biodiesel Reseller or a certificate from the
provider identifying the product as renewable diesel and, if applicable, a statement from the reseller
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
DO NOT SIGN THIS FORM.
For Paperwork Reduction Act Notice, see your tax return instructions.
Cat. No. 62766T
Form 
8453
 (2013)
City
ZIP Code
Declaration Control Number (DCN)
00 - 
- 3
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