Form Pa-8879-P - Pennsylvania E-File Signature Authorization For Pa S Corporation/partnership Information Return (Pa-20s/pa-65) - Directory Of Corporate Partners (Pa-65 Corp) - 2016 Page 3
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3Form PA-8879-P
ELECTRONIC SIGNATURE SPECIFICATIONS
Page 3
(05-16)
Purpose of Electronic Signature
Signature of the General Partner,
initiate an electronic funds withdrawal
Specifications
Limited Liability Company member,
from the account designated in the
S Corporation Officer, Authorized
The electronic signature specifications
electronic payment portion of my 2016
Partner or Representative
identifies
the
perjury,
consent
to
PA S Corporation/Partnership Information
I am signing this return and Electronic
disclosure and electronic funds withdrawal
Return (PA-20S/PA-65) - Directory of
Funds Withdrawal Consent, if applicable,
text selections used to develop jurat
Corporate Partners (PA-65 Corp) for
by entering my federal self-selected PIN
language statements for electronic filing
payment of my Pennsylvania withholding.
below.
tax preparation software where the
I also authorize my financial institution to
Authorized PIN: __ __ __ __ __
practitioner federal self-selected PIN
debit the entry to my account and the
method is selected. The software must
financial institutions involved in the
Date:
provide the capability to incorporate
processing of my electronic payment to
these into the appropriate text for
receive confidential information necessary
Electronic Return Originator
presentation to a taxpayer for their review.
to answer inquiries and resolve issues
Declaration
Perjury Statement
related to my payment.
I declare that the information contained
Under penalties of perjury, I declare I am
I understand that the federal Office of
in this electronic return is the information
a general partner, limited liability company
Foreign Assets Control has imposed
furnished to me by the entity. If the entity
member, S corporation officer, authorized
additional reporting requirements on all
furnished to me a completed return, I
partner or representative of the above
electronic banking transactions that
declare the information contained in this
entity, and I have examined a copy of the
directly involve a financial institution
electronic return is identical to that
entity’s 2016 electronic PA S Corporation/
outside of the territorial jurisdiction of the
contained in the return provided by the
Partnership Information Return (PA-20S/
U.S. These transactions are called
entity. If the furnished return was signed
PA-65) and/or Directory of Corporate
by a paid preparer, I declare I have
international ACH transactions (IAT). I
Partners (PA-65 Corp) and accompanying
entered the paid preparer’s identifying
understand
that
presently
the
PA
schedules and statements. To the best of
information in the appropriate portion of
Department of Revenue does not support
my knowledge and belief, all are true,
this electronic return. If I am the paid
IAT ACH debit transactions. I certify that
correct and complete.
preparer, under the penalties of perjury, I
the transactions do not directly involve a
Consent To Disclosure
declare I have examined this electronic
financial
institution
outside
of
the
return, and to the best of my knowledge
I consent to allow my electronic return
territorial jurisdiction of the U.S. at any
and belief it is true, correct and complete.
originator (ERO) or transmitter to send the
point in the process.
Electronic Return Originator
entity’s return to the Internal Revenue
Signature
To revoke a payment, I must notify the
Service (IRS) and subsequently by the
PA Department of Revenue no later than
IRS to the PA Department of Revenue.
I am signing this return by entering my
two business days prior to the debit date.
Electronic Funds Withdrawal Consent
federal self-selected PIN below.
I understand that notification must be
ERO PIN: _ _ _ _ _ _ and _ _ _ _ _
made by email to ra-achrevok@pa.gov or
I authorize the PA Department of Revenue
and its designated financial institution to
fax at 717-772-9310.
(EFIN)
(PIN)
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