Form Rev-421 Ad - Bulk Order Request - 2012 printable pdf download

REV-421 AD (10-12)

2012

PENNSYLVANIA TAX FORMS

Note your customer number

printed above your name

BULK ORDER REQUEST

Bureau of Administrative Services

and address.

711 Gibson Blvd.

Harrisburg PA 17104-3218

717-985-3207

INSTRUCTIONS FOR ORDERING 2012 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 2012 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,

PLEASE MAKE CORRECTIONS HERE:

You have been issued separate, unique customer numbers for

each of your locations. Please use the number corresponding to

the location of where forms are to be delivered.

Customer Number

Print your return mailing address in the space provided.

Affix stamp where indicated.

Customer Name

You can also place your order online at You will

Address

need your customer number.

City ___________________________________ State _____ ZIP Code ________________

QUANTITY

FORM NUMBER

DESCRIPTION

PA40IN

2012 Individual Income Tax Return “Instructions Only” Booklet (contains no forms)

PA40-1

2012 Long Form (single sheet – not reproducible)

PA40A/B/D

2012 Interest/Dividends/Sale, Exchange or Disposition of Property

PA40W2S/SP

2012 Wage Statement Summary/Special Tax Forgiveness Credit

PA40C

Profit or Loss from Business or Profession

PA40C-EZ

Short Form Profit from Business or Profession

PA40F

Farm Income and Expenses

PA40D/E

Sale, Exchange or Disposition of Property/Rents and Royalty Income

PA40UE

Allowable Employee Business Expenses

PA40J/T/O

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

PA40OC

Other Credits

PA40G-L

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

PA40G-R

Reconciliation of Taxes Paid to Other States or Countries

PA40G-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)

PA40ENV

Envelope for Mailing Tax Returns

PA1000

2012 Property Tax/Rent Rebate Booklet

All forms above are new or have been revised for 2012.

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 - Bulk Order Request - 2012

Related Articles

Related forms

Related Categories