Instructions For Form Rev-854 - Pa Corporation Taxes Ein/tax Year/address Change Coupon

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INSTRUCTIONS FOR REV-854
PA CORPORATION TAXES EIN/TAX YEAR/ADDRESS CHANGE COUPON
1. Enter account information including Tax Account ID, employer identification number (EIN),
corporation name, current tax year begin, current tax year end and complete mailing address.
2. Enter changes in account information on the right-hand side of the coupon including EIN, tax year
begin, tax year end, and address. If the address has changed, enter the entire new address on the
form. Do not use this coupon to change a corporation name. Call the Department of State, Corporation
Bureau at 717-787-1057 (Option 4) and speak to a customer service representative for change of name
information.
3. Signature, title, date, email address and telephone number should be provided by a
representative of the corporation.
4. Mail coupon to:
PA DEPARTMENT OF REVENUE
PO BOX 280709
HARRISBURG, PA 17128-0709
DETACH HERE BEFORE MAILING
✁
REV-854 CT (04-11)
DEPT USE ONLY
PA CORPORATION TAXES
REV-854 EIN/TAX YEAR/ADDRESS CHANGE
BUREAU OF CORPORATION TAXES
1.
1.
CURRENT EIN
NEW EIN
TAX ACCOUNT ID
CORPORATION NAME
2. NEW TAX YEAR BEGIN
3. NEW TAX YEAR END
MM
DD
YYYY
MM
DD
YYYY
2. CURRENT TAX YEAR BEGIN
3. CURRENT TAX YEAR END
MM
DD
YYYY
MM
DD
YYYY
4. NEW ADDRESS
STREET
4. CURRENT ADDRESS
STREET
CITY
STATE
ZIP
CITY
STATE
ZIP
DO NOT ENCLOSE OTHER COUPONS OR PAYMENTS.
SIGNATURE
TITLE
DATE
EMAIL
TELEPHONE

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