Form Pa-8879-F - Pennsylvania E-File Signature Authorization - For Pa-41 - 2015
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1Pennsylvania e-file Signature
authorization — for Pa-41
2015
Pa-8879-F
Form
START
Declaration Control Number/Submission ID
Employer Identification Number
Name of Estate or Trust
Name and Title of Fiduciary
PaRt i tax Return information – tax year Ending Dec. 31, 2015 (Whole dollars only)
1. Net PA Taxable Income (Form PA-41, Line 9)
. . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.
2. PA Tax Liability (Form PA-41, Line 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.
3. Total Payments and Credits (Form PA-41, Line 18) . . . . . . . . . . . . . . . . . . . . . . . . .
3.
4. Overpayment (Form PA-41, Line 23) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.
5. Total Payment (Tax Due) (Form PA-41, Line 22) . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.
Under penalties of perjury, I declare that the amounts above match the amounts shown on the corresponding lines of the
electronic portion of the 2015 PA Fiduciary Income Tax Return. I have also examined a copy of the return being filed
electronically with the PA Department of Revenue and all accompanying schedules and statements. I consent to allow my
electronic return originator (ERO), transmitter, or intermediate service provider to send the estate’s or trust’s return to the
PA Department of Revenue and to receive from the PA Department of Revenue an acknowledgement of receipt or reason of
rejection of the transmission. If applicable, I authorize the PA Department of Revenue 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 the estate’s or trust’s state taxes owed on this return, and I authorize the financial institution to debit
the entry to this account. To revoke a payment, I must contact the PA Department of Revenue no later than two business days
prior to the payment (settlement) date. I understand notification must be made in writing by email to re-achrevok@pa.gov
or fax to 717-772-9310.
Fiduciary’s (PiN): (check one box only)
I authorize
to enter my PIN
as my signature on the
estate’s or trust’s 2015 electronically filed income tax return.
As a fiduciary or officer representing the fiduciary of the estate or trust, I will enter my PIN as my signature on the estate’s
or trust’s 2015 electronically filed income tax return.
MMDDYYYY
Signature of Officer – Please sign after printing
Signature
Date
Practitioner PiN Program Participants Only – Continue below
PaRt iii Certification and authentication
/
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 2015 electronically filed income tax return for the estate or trust indicated above. I confirm I am participating in the
Practitioner PIN Program in accordance with the requirements established for this program.
MMDDYYYY
ERO’s signature
Signature of ERO – Sign after printing
Date
ERO must retain this form and the supporting documents for three years.
DO NOt Submit thiS FORm tO thE PENNSylvaNia DEPaRtmENt OF REvENuE.
Reset Entire Form
RETURN TO TOP
PRINT FORM
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