Fillable Form Rev-1605 Ct Schedule Co - Names Of Corporate Officers printable pdf download

Form Rev-1605 Ct Schedule Co - Names Of Corporate Officers

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INSTRUCTIONS FOR REV-1605

SCHEDULE CO – NAMES OF CORPORATE OFFICERS

NOTE: Corporations may update names of corporate officers electronically through e-TIDES at

1. The Department of Revenue is required to forward the names of corporate officers received with

tax reports to the PA Department of State for inclusion in the public records of the corporation. This

information is provided from the corporate officer section of the Pennsylvania tax report. Corporations

may also update this information during the year by completing the Corporate Officer Schedule, REV-1605,

and submitting it to the PA Department of Revenue, which will forward this information to the PA

Department of State for inclusion in the public records of the corporation.

2. All fields below must be completed with current information so that records may be updated accurately

and comprehensively.

3. An officer or a representative of the corporation must complete and sign the form.

4. Mail Schedule CO to:

PA DEPARTMENT OF REVENUE

327 WALNUT ST FL 3

PO BOX 280701

HARRISBURG PA 17128-2005

FILL IN FORM USING ALL CAPS.

DO NOT USE DASHES (-) OR SLASHES (/) IN ANY FIELD. ENTER DATES AS MMDDYYYY. USE WHOLE DOLLARS ONLY.

DETACH HERE BEFORE MAILING

START

BUREAU OF CORPORATION TAXES

NAMES OF

REV-1605

CT (06-15)

PO BOX 280701

REVENUE ID

CORPORATE OFFICERS

SCHEDULE CO

HARRISBURG PA 17128-2005

CORPORATE OFFICERS

SSN

LAST NAME

FIRST NAME

PRESIDENT/MANAGING PARTNER

VICE PRESIDENT

SECRETARY

TREASURER/TAX MANAGER

BUSINESS NAME

EIN

STREET ADDRESS

CITY

STATE

ZIP CODE

By filing this form, the taxpayer consents to the release of the names of its corporate officers and its address to the Department of State where it will be

available as a public record. I hereby affirm under penalties prescribed by law that information contained in this form is true and correct to the best of my

knowledge and that I am authorized to execute this form on behalf of the taxpayer.

MMDDYYYY

PREPARER’S SIGNATURE

TITLE

DATE

TELEPHONE

PLEASE SIGN AFTER PRINTING.

PRINT FORM

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