E-File Signature Authorization Form - City Of Philadelphia - 2014
Download a blank fillable E-File Signature Authorization Form - City Of Philadelphia - 2014 in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete E-File Signature Authorization Form - City Of Philadelphia - 2014 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1City of Philadelphia
e-file Signature Authorization
2014
Do not send to the City of Philadelphia.
This is not a tax return. Keep this form for your records.
Submission Identification Number (SID)
Taxpayer’s Name
Social Security Number
Part I
Tax Return Information – Tax Year Ending December 31, 2014 (Whole Dollars Only)
1
Tax Due for the 2014 Business Income & Receipts Tax (Form 2014 BIRT, Line 3)
1
2
MANDATORY 2015 BIRT Estimated Payment (Form 2014 BIRT, Line 4)
2
3
Total Due by 4/15/2015 (Line 1 plus Line 2)
3
Part II
Taxpayer Declaration and Signature Authorization
Under penalties of perjury, I declare that I have examined a copy of my electronic tax return and accompanying schedules and
statements for the tax year ending December 31, 2014, and to the best of my knowledge and belief, it is true, correct, and co mplete. I
further declare that the amounts in Part I above are the amounts from my electronic tax return. I consent to allow my intermediate
service provider, transmitter, or electronic return originator (ERO) to send my return to the City of Philadelphia and to receive from the
City of Philadelphia (a) an acknowledgement of receipt or reason for rejection of the transmission and (b) the reason for any delay in
processing the return. If applicable, I authorize the City of Philadelphia and its designated financial agent to initiate an electronic funds
withdrawal (direct debit) entry to the financial institution account indicated in the tax preparation software for payment of my City taxes
owed on this return and/or a payment of estimated tax, and the financial institution to debit the entry to this account. 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 tax return and, if applicable, my electronic funds withdrawal consent.
Taxpayer’s Personal Identification Number (PIN): (check one box only)
I authorize __________________________________________ to enter my PIN
as my
signature on my tax year 2014 electronically filed tax return.
I will enter my PIN as my signature on my tax year 2014 electronically filed tax return.
Signature _____________________________________________________________
Date
_
______________________
Practitioner PIN Method Returns Only—continue below
Certification and Authentication—Practitioner PIN Method Only
Part III
ERO’s EFIN/PIN. Enter your six-digit EFIN followed by your five-digit self-selected PIN.
As a participant in the Practitioner PIN Program, I certify the above numeric entry is my PIN, which is my signature on the tax
year 2014 electronically filed tax return for the taxpayer indicated above. I confirm I am participating in the Practitioner PIN
Program in accordance with the requirements established for this program.
ERO’s signature ________________________________________________________
Date
_______________________
ERO must retain this form and the supporting documents for three years.
DO NOT SUBMIT THIS FORM TO THE CITY OF PHILADELPHIA.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Pa-8879-c - Pennsylvania E-file Signature Authorization For Corporate Tax Report Rct-101 - 2014
Financial
Form Pa-8879-c - Pennsylvania E-file Signature Authorization For Corporate Tax Report Rct-101 - 2014
Financial
Related Categories
Parent category: Financial