Form Pa-8879-C - Pennsylvania E-File Signature Authorization For Corporate Tax Report Rct-101 (2007) Page 3

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APPENDIX 2
ELECTRONIC SIGNATURE SPECIFICATIONS
Appendix 2 identifies the Perjury, Consent to Disclosure and Electronic Funds Withdrawal text selections used to develop jurat language state-
ments for electronic filing tax preparation software where the Practitioner Federal Self Select PIN method is selected. The software must pro-
vide the capability to incorporate these into the appropriate text for presentation to a taxpayer for his or her review.
PERJURY STATEMENT
Under penalties of perjury, I declare that I am an officer of the above corporation and that I have examined a copy of the corporation’s 2007
electronic PA Corporate Tax Report (RCT-101) and accompanying schedules and statements, and to the best of my knowledge and belief, it
is true, correct and complete.
CONSENT TO DISCLOSURE
I consent to allow my Electronic Return Originator (ERO) or transmitter to send the corporation’s return/report to the Internal Revenue Service
(IRS) and subsequently by the IRS to the PA Department of Revenue.
ELECTRONIC FUNDS WITHDRAWAL CONSENT
I authorize (1) the PA Department of Revenue and its designated Financial Institution to initiate an Electronic Funds Withdrawal entry to my
financial institution account designated in the electronic payment portion of my 2007 PA Corporate Tax Report for payment of my Pennsylvania
taxes owed, and (2) my financial institution to debit the entry to my account. I also authorize the financial institutions involved in the process-
ing of my electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to my pay-
ment. Under the terms of this authorization, I can revoke this authorization by notifying the PA Department of Revenue no later than two busi-
ness days prior to the payment (settlement) date. I understand that notification must be made by one of the following methods: e-mail at
ra-mef@state.pa.us; fax (717) 772-4805; or telephone (717) 705-2131.
OFFICER’S SIGNATURE
I am signing this tax return/report and Electronic Funds Withdrawal Consent, if applicable, by entering my Federal Self Selected PIN below.
Officer’s PIN: _ _ _ _ _
Date: ___________
ERO DECLARATION
I declare that the information contained in this electronic tax return/report is the information furnished to me by the corporation. If the corpo-
ration furnished me a completed tax return/report, I declare that the information contained in this electronic tax return/report is identical to that
contained in the return/report provided by the corporation. If the furnished return/report was signed by a paid preparer, I declare I have entered
the paid preparer’s identifying information in the appropriate portion of this electronic return/report. If I am the paid preparer, under the penal-
ties of perjury, I declare that I have examined this electronic return/report, and to the best of my knowledge and belief, it is true, correct and
complete. This declaration is based on all information of which I have any knowledge.
ERO SIGNATURE
I am signing this tax return/report by entering my Federal Self Selected PIN below.
ERO’s PIN: _ _ _ _ _ _ and _ _ _ _ _
(EFIN)
(PIN)

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