Form Rev-421 Ad - Pennsylvania Tax Forms Bulk Order Request

REV-421 AD (10-13)

2013

PENNSYLVANIA TAX FORMS

Note your customer number

printed above your name

BULK ORDER REQUEST

Bureau of Administrative Services

and address.

327 Walnut St. FL 9

Harrisburg PA 17128-2005

717-772-9311

INSTRUCTIONS FOR ORDERING 2013 INCOME TAX & PROPERTY TAX/RENT REBATE FORMS

To request Pennsylvania income tax and/or property tax rent rebate forms, indicate the quantity below, then fax this form to 717-985-3234 or fold, tape

and return this order form to the PA Department of Revenue. Be sure to include your name, address and customer number. Allow one to two weeks for

delivery.

In order to control rising mailing and printing costs, please do not order forms dated prior to 2013 or more forms than you need. For your convenience,

another order form will be included in your order when it is shipped.

Please make note of your customer number and indicate it on all

subsequent reorders and/or correspondence.

IF ADDRESS INFORMATION IS INCORRECT OR HAS CHANGED,

You have been issued separate, unique customer numbers for

PLEASE MAKE CORRECTIONS HERE:

each of your locations. Please use the number corresponding to

the location of where forms are to be delivered.

Print your return mailing address in the space provided.

Customer Number

Affix stamp where indicated.

Customer Name

You can also place your order online at You will

need your customer number.

Address

NOTE: Mailing of PA-40 forms and instructions will begin on

Dec. 18, 2013; Mailing of PA-1000 forms and instructions will

begin on Feb. 11, 2014.

City ___________________________________ State _____ ZIP Code ___________

QUANTITY

FORM NUMBER

DESCRIPTION

PA-40IN*

2013 Personal Income Tax Instructions Only Booklet (contains no forms)

PA-40-1*

2013 Long Form (single sheet – not reproducible)

PA-40A/B/D*

2013 Interest/Dividends/Sale, Exchange or Disposition of Property

PA-40W2S/SP*

2013 Wage Statement Summary/Special Tax Forgiveness Credit

PA-40C*

Profit or Loss from Business or Profession

PA40C-EZ

Short Form Profit from Business or Profession

PA-40F*

Farm Income and Expenses

PA-40E*

Rents and Royalty Income

PA-40UE*

Allowable Employee Business Expenses

PA-40J/T/O*

Income from Estates or Trusts/Gambling and Lottery Winnings/Other Deductions

PA-40OC*

Other Credits

PA-40G-L

Credit for Income Tax Paid by PA Resident to Other State or Country (long version)

PA-40G-R

Reconciliation of Taxes Paid to Other States or Countries

PA-40G-S

Credit for Income Tax Paid by PA Resident to Other State or Country (short version)

REV-276*

Application for Extension of Time to File (not reproducible)

PA-40ENV*

Envelope for Mailing Tax Returns

PA-1000*

2013 Property Tax/Rent Rebate Booklet

*These forms are new or have been revised for 2013.

ENTER OTHER FORM REQUESTS BELOW.

PACE, FICTITIOUS NAME AND MOTOR VEHICLE INFORMATION

PACE contact:

FICTITIOUS NAME contact:

MOTOR VEHICLE contact:

DEPARTMENT OF AGING

DEPARTMENT OF STATE

PENNDOT

PO BOX 8806

CORPORATION BUREAU

BUREAU OF MOTOR VEHICLES

HARRISBURG PA 17105-8806

NORTH OFFICE BLDG RM 206

RIVERFRONT OFFICE 1101 S FRONT ST

1-800-225-7223

HARRISBURG PA 17120

HARRISBURG PA 17104

1-888-659-9962

1-800-932-4600

Form Rev-421 Ad - Pennsylvania Tax Forms Bulk Order Request - 2013

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