Form Rct-101-I - Inactive Pa Corporate Tax Report Page 3

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1019014305
REVENUE ID
TAX YEAR END
NAME
RCT-101-I
PAGE 3 OF 3 INACTIVE PA CORPORATE TAX REPORT 20_ _
(FI)
STEP J: CORPORATE STATUS CHANGES
XX
Final Report
PA Corporations:
XX
XX
If yes, enter date all business activity ceased
Did you ever transact business anywhere?
XX
XX
If yes, enter date of final disposition of assets
Did you hold assets anywhere?
Foreign Corporations:
XX
XX
If yes, enter date PA business activity ceased
Did you ever transact business in PA?
XX
XX
If yes, enter date of final disposition of
Did you hold assets in PA?
PA assets
XX
XX
Reinstatement
Effective Date of
Reinstatement
CORPORATE OFFICERS
SSN
Last Name
First Name
MI
(See instructions.)
XX
President/Managing Partner
XX
Vice President
XX
Secretary
XX
Treasurer/Tax Manager
PREPARER’S INFORMATION
XX
Mail to Preparer
XX
Firm Federal EIN
XX
Firm Name
XX
Address Line 1
XX
Address Line 2
XX
City
XX
State
XX
ZIP
I affirm under penalties prescribed by law this report, including any accompanying schedules and statements, has been prepared by me and to the best of my
knowledge and belief is a true, correct and complete report.
Tax Preparer’s Signature
Date
PLEASE SIGN AFTER PRINTING.
INDIVIDUAL PREPARER
PHONE
EMAIL
PTIN/SSN
PRINT FORM
Reset Entire Form
RETURN TO TOP
RETURN TO PAGE ONE
1019014305
1019014305

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