Form Pa-65 Corp - Directory Of Corporate Partners - 2014
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11408110052
PA-65 Corp
Directory of
Corporate Partners
2014
PLEASE PRINT. USE BLACK INK.
PA-65 Corp
(05-14) (FI)
OFFICIAL USE ONLY
9 DIGIT - NO DASH
Partnership FEIN
Partnership Business Name
START
C
First Line of Address
Street Address - If Address has Apartment Number, Suite, RR No. - Place on this Line.
100% Corp. Owned
Use ALL CAPITAL LETTERS for address information.
Second Line of Address
PO Box
Payment enclosed
City or Post Office
State
ZIP Code
Amended PA-65 Corp
Submit a complete federal Form 1065 for the entity above and Schedule K-1 for each corporate partner listed below.
Copy the PA-65 Corp to list additional corporate partners. Enter whole dollars only.
1 List each corporate partner:
FEIN
9 DIGIT - NO DASH
Revenue ID
Nonfiling Corporation CNI Tax Withholding
Foreign Entity
a
Outside U.S.
If a loss, enter "0"
C
Name of Corporate Partner
RCT-101 Filed
Street Address
City
State
ZIP Code
FEIN
9 DIGIT - NO DASH
Revenue ID
Nonfiling Corporation CNI Tax Withholding
Foreign Entity
b
Outside U.S.
If a loss, enter "0"
C
Name of Corporate Partner
RCT-101 Filed
Street Address
City
State
ZIP Code
9 DIGIT - NO DASH
FEIN
Revenue ID
Nonfiling Corporation CNI Tax Withholding
Foreign Entity
c
Outside U.S.
If a loss, enter "0"
C
Name of Corporate Partner
RCT-101 Filed
Street Address
City
State
ZIP Code
2 Total number of corporate
4 Total CNI Tax Withholding for all nonfiling
partners for this entity.
corporate partners for this entity.
3 Total number of corporate partners
If a loss, enter "0"
registered in PA for this entity.
5 PA Apportionment as reported on PA-20S/PA-65 Schedule H-Corp.
●
Under penalties of perjury, I declare I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and
belief, it is true, correct and complete. Declaration of paid preparer is based on all information of which preparer has any knowledge.
MM/DD/YY
Print/Type name of general partner, principal officer or
Signature of general partner, principal officer or
Date
Daytime phone no.
authorized individual
authorized individual
Please Sign Your Return after printing.
Paid Preparer’s Use Only
Print/Type preparer’s name
Preparer’s signature
Date
Daytime phone no.
Please Sign Your Return after printing.
Check if self-employed
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1408110052
1408110052
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Parent category: Financial