Form Rev-1705 (B) As - Tax Account Information Change/correction Form

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COMMONWEALTH OF PENNSYLVANIA
PUBLIC TRANSPOR TATION
DEPARTMENT OF REVENUE
ASSISTANCE FUND TAXES
O N LY USE BLACK OR BLUE INK
AND FEES
TO COMPLETE FORMS.
DO NOT USE RED INK OR PENCIL.
I M P O R T A N T
C O N T E N T S :

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