8836-SP Qualifying Children Residency Statement (Spanish version

Caution: DRAFT FORM
This is an advance proof copy of an IRS tax form.
It is subject to change and OMB approval before it
is officially released. You can check the scheduled
release date on our web site (www.irs.gov).
If you have any comments on this draft form, you can
submit them to us on our web site. Include the word
DRAFT in your response. You may make comments
anonymously, or you may include your name and
e-mail address or phone number. We will be unable
to respond to all comments due to the high volume
we receive. However, we will carefully consider
each suggestion. So that we can properly consider
your comments, please send them to us within 30
days from the date the draft was posted.

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I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 8879, PAGE 1 OF 2
MARGINS; TOP 13mm (1⁄ 2 "), CENTER SIDES.
PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 216mm (81⁄ 2 ") x 279mm (11")
PERFORATE: None
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Date

Form

8879

©
©

Declaration Control Number (DCN)
Taxpayer’s name

©

Signature

O.K. to print
Revised proofs
requested

OMB No. 1545-0074

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2006

Do not send to the IRS. This is not a tax return.
Keep this form for your records. See instructions.

Social security number

Spouse’s name

1
2
3
4
5

Date

IRS e-file Signature Authorization

Department of the Treasury
Internal Revenue Service

Part I

Action

Spouse’s social security number

Tax Return Information—Tax Year Ending December 31, 2006 (Whole Dollars Only)

Adjusted gross income (Form 1040, line 38; Form 1040A, line 22; Form 1040EZ, line 4)
Total tax (Form 1040, line 63; Form 1040A, line 37; Form 1040EZ, line 11)
Federal income tax withheld (Form 1040, line 64; Form 1040A, line 38; Form 1040EZ, line 7)
Refund (Form 1040, line 74a; Form 1040A, line 45a; Form 1040EZ, line 12a, Form 1040EZ-T, line 1a)
Amount you owe (Form 1040, line 76; Form 1040A, line 47; Form 1040EZ, line 13)

Part II

1
2
3
4
5

Taxpayer Declaration and Signature Authorization (Be sure you get and keep a copy of your return)

Under penalties of perjury, I declare that I have examined a copy of my electronic individual income tax return and accompanying schedules and statements
for the tax year ending December 31, 2006, and to the best of my knowledge and belief, it is true, correct, and complete. I further declare that the amounts
in Part I above are the amounts from my electronic income tax return. I consent to allow my intermediate service provider, transmitter, or electronic return
originator (ERO) to send my return to the IRS and to receive from the IRS (a) an acknowledgement of receipt or reason for rejection of the transmission, (b)
an indication of any refund offset, (c) the reason for any delay in processing the return or refund, and (d) the date of any refund. If applicable, I authorize the
U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution account indicated
in the tax preparation software for payment of my Federal taxes owed on this return and/or a payment of estimated tax, and the financial institution to debit
the entry to this account. I further understand that this authorization may apply to future Federal tax payments that I direct to be debited through the Electronic
Federal Tax Payment System (EFTPS). In order for me to initiate future payments, I request that the IRS send me a personal identification number (PIN) to
access EFTPS. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. 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. I further acknowledge that the personal identification number (PIN) below is my signature for my electronic
income tax return and, if applicable, my Electronic Funds Withdrawal Consent.

Taxpayer’s PIN: check one box only
I authorize

to enter or generate my PIN
ERO firm name

do not enter all zeros

as my signature on my tax year 2006 electronically filed income tax return.
I will enter my PIN as my signature on my tax year 2006 electronically filed income tax return. Check this box only if you
are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III
below.
Your signature

©

Date

©

Spouse’s PIN: check one box only
I authorize

to enter or generate my PIN
ERO firm name

do not enter all zeros

as my signature on my tax year 2006 electronically filed income tax return.
I will enter my PIN as my signature on my tax year 2006 electronically filed income tax return. Check this box only if you
are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III
below.
Spouse’s signature

©

Date

©

Practitioner PIN Method Returns Only—continue below
Part III

Certification and Authentication—Practitioner PIN Method Only

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 for the tax year 2006 electronically filed income tax return for the taxpayer(s) indicated
above. I confirm that I am submitting this return in accordance with the requirements of the Practitioner PIN method and Publication 1345, Handbook for
Authorized IRS e-file Providers of Individual Income Tax 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 Privacy Act and Paperwork Reduction Act Notice, see back of form.

Cat. No. 32778X

Form

8879

(2006)