Form Rev-857 Ct - Estimated Tax Payment

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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.
3. Signature, title, date, email address and telephone number must be provided by a representative
of the corporation.
4. Make check payable to “PA Department of Revenue” equal to the total payment on Line 3. Mail the check
and coupon to:
PA DEPARTMENT OF REVENUE
PO BOX 280422
HARRISBURG PA 17128-0422
5. For information on electronic filing options, visit the e-Services Center at
6. Must use mmddyyyy format in all date fields.
DO NOT USE DASHES (-) OR SLASHES (/) IN ANY FIELDS. ENTER DATE AS MMDDYYYY.
✁
DETACH HERE BEFORE MAILING
REV-857 CT (06-12)
DEPT USE ONLY
PA CORPORATION TAXES
REV-857 ESTIMATED TAX PAYMENT
BUREAU OF CORPORATION TAXES
FILE PERIOD BEGIN
FILE PERIOD END
REVENUE ID
QTR
QUARTER DUE DATE
CORPORATION NAME
1. CS/FF TAX PAYMENT
.00
STATE OF INCORPORATION
EIN
2. CNI TAX PAYMENT
.00
ADDRESS
3. TOTAL PAYMENT
$
STREET
.00
0
(Add Lines 1 and 2.)
Make checks payable to “PA DEPT OF REVENUE.”
CITY
STATE
ZIP
If payment is being made electronically, do not mail
this coupon.
PRINT
RESET
PLEASE READ THE INSTRUCTIONS BEFORE COMPLETING THIS COUPON.
SIGNATURE
TITLE
DATE
EMAIL
TELEPHONE
Please sign after printing.

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