Form Rev-857 - Pa Corporation Taxes Estimated Tax Payment Coupon

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DO NOT USE THIS COUPON IF YOUR PAYMENT EXCEEDS $1,000
INSTRUCTIONS FOR REV-857
PA CORPORATION TAXES ESTIMATED TAX PAYMENT COUPON
Do not mail this coupon if payment is being made electronically.
1. Enter account information including file period begin, file period end, Revenue ID, quarter for which
payment is being made, quarter due date, corporation name, state of incorporation, EIN and complete
mailing address.
2. Enter payments required for capital stock/foreign franchise (CS/FF) and corporate net income (CNI)
taxes. Also enter total payment. If no payment is being made for a tax, enter zero. If no payment is
required for either tax, do not submit this form.
NOTE: All payments of $1,000 or more must be made electronically or by certified or cashier’s check
remitted in person or by express mail courier. For information on electronic filing options, visit the
e-Services Center at
3. If less than $1,000, you may mail the coupon and a check made payable to PA Department of Revenue.
PA DEPARTMENT OF REVENUE
PO BOX 280422
327 WALNUT ST FL 3
HARRISBURG PA 17128-2005
4. Signature, title, date, email address and telephone number must be provided by a representative
of the corporation.
5. Must use mmddyyyy format in all date fields.
FILL IN FORM USING ALL CAPS.
DO NOT USE DASHES (-) OR SLASHES (/) IN ANY FIELD. ENTER DATES AS MMDDYYYY. USE WHOLE DOLLARS ONLY.
PLEASE READ THE INSTRUCTIONS BEFORE COMPLETING THIS COUPON.
DETACH HERE BEFORE MAILING
REV-857 CT (06-15)
DEPT USE ONLY
PA CORPORATION TAXES
REV-857 ESTIMATED TAX PAYMENT
BUREAU OF CORPORATION TAXES
FILE PERIOD END
REVENUE ID
QTR
QUARTER DUE DATE
FILE PERIOD BEGIN
CORPORATION NAME
1. CS/FF TAX PAYMENT
.00
STATE OF INCORPORATION
EIN
2. CNI TAX PAYMENT
.00
ADDRESS
3. TOTAL PAYMENT
$
.00
STREET
0
(Add Lines 1 and 2.)
Make check payable to “PA DEPT OF REVENUE.”
CITY
STATE
ZIP
If payment is being made electronically, do not mail
this coupon.
RESET
PRINT
SIGNATURE
TITLE
DATE
EMAIL
TELEPHONE
Please sign after printing.

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