Form Rev-1605 (Shedule Co) - Names Of Corporate Officers - 2001
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2PA DEPARTMENT OF REVENUE
NAMES OF
REV-1605
BUREAU OF CORPORATION TAXES
CT (6-01)
ACCOUNT
DEPT. 280430
CORPORATE OFFICERS
ID
HARRISBURG, PA 17128-0430
Complete and mail this schedule to the PA Department of Revenue
LAST NAME
at the above address. The following information is requested under
OF
the provision of Article 4 of the Tax Reform Code of 1971.
PRESIDENT
SOCIAL
FIRST NAME
OF
MI
SECURITY
PRESIDENT
NUMBER
LAST NAME
OF VICE
PRESIDENT
SOCIAL
FIRST NAME
OF VICE
MI
SECURITY
PRESIDENT
NUMBER
LAST NAME
OF
SECRETARY
SOCIAL
FIRST NAME
OF
MI
SECURITY
SECRETARY
NUMBER
LAST NAME
OF
TREASURER
SOCIAL
FIRST NAME
OF
MI
SECURITY
TREASURER
NUMBER
THIS FORM IS CONTINUED ON THE REVERSE. Please turn to the reverse side of this form and continue filling in all applicable fields.
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