R-8453CP (1/19)
                                 Louisiana Department of Revenue                                                                2018
                                        Composite Partnership Tax                                                               LA8453-CP
                                 Declaration for Electronic Filing

Do not file paper copies. This form must be maintained by the Electronic Return Originator (ERO).
For calendar year 2018, or tax year beginning ____________, 2018, ending ___________, 2019
                                                                                                                PLEASE PRINT OR TYPE
Name of Partnership

Louisiana Revenue Account Number                                   Federal Employer Identification Number (FEIN)

Street Address of Partnership                                      City                               State     ZIP

Part 1 - Tax Return Information (whole dollars only)
1    Income tax due after Priority 1 Credits (Form R-6922, Line 4)                            1                                 .00

2    Refund (Form R-6922, Line 20)                                                            2                                 .00

3    Total amount due (Form R-6922, Line 25)                                                  3                                 .00

4    Amount of payment remitted electronically                                                4                                 .00
Part II - Declaration of Officer (Sign only after Part I is completed.)
Under penalties of perjury, I declare that I am a partner or member of the above entity and that the information that I have given my 
electronic return originator (ERO), transmitter, and/or intermediate service provider (ISP) and the amounts in Part 1 above agree with 
the amounts on the corresponding lines of the Louisiana 2018 Composite Partnership tax return. To the best of my knowledge and belief, 
the composite partnership return is true, correct, and complete. I consent to my ERO, transmitter, and/or ISP sending the composite 
partnership return, this declaration, accompanying schedules, and statements to the Louisiana Department of Revenue. I also consent 
to the Louisiana Department of Revenue sending my ERO, transmitter, and/or ISP an acknowledgment of receipt of transmission and 
an indication of whether or not the composite partnership return is accepted, and, if rejected, the reason(s) for the rejection.
■ I authorize a representative of the Louisiana Department of Revenue to discuss my return and attachments with my preparer.
Signature of Officer                         Date (mm/dd/yyyy)                           Title

Part III - Declaration of Electronic Return Originator (ERO) and Paid Preparer
I declare that I have reviewed the above composite partnership return and that the entries on LA8453-CP 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. A partner or member of the entity will have signed this form before I submit the return. I will give the 
partner or member a copy of all forms and information to be filed with the Louisiana Department of Revenue, and have followed all other 
requirements in Pub. 3112, IRS E-file Application and Participation, and Pub. 4163, Modernized E-File Information for Authorized IRS 
E-Providers.  If I am also the Paid Preparer, under penalties of perjury I declare that I have examined the above composite partnership
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.
ERO’s Use Only
ERO’S Signature                              Date (mm/dd/yyyy)     ■  Check if also ■    Check if     ERO’s SSN or PTIN
X                                                                    paid preparer       self-employed
Firm’s Name (or yours if self-employed)                                                               FEIN

City                                                                    State       ZIP               Phone Number

Paid Preparer’s Use only
Preparer’s Signature                         Date (mm/dd/yyyy)     ■  Check if      Preparer’s SSN or PTIN
                                                                      self-employed
Firm’s Name (or yours if self-employed)                                                               FEIN

City                                                                    State       ZIP               Phone Number