Form Pa-20s/pa-65 - Partner/member/ Shareholder Directory - 2013

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1307610053
PARTNER/MEMBER/
SHAREHOLDER DIRECTORY
PA-20S/PA-65
2013
Directory
(05-13) (FI)
OFFICIAL USE ONLY
9 DIGIT - NO DASH
Name as shown on the PA-20S/PA-65 Information Return
FEIN
START
C
The entity must list its partners/members/shareholders on this schedule. Enter the following for all partners/members/shareholders:
SSN/FEIN; REVENUE ID; OWNERSHIP % (enter each owner’s percentage); and NAME AND ADDRESS. Copy Directory to list additional owners.
CODE - Enter the type of owner by code.
See instructions.
DE = Disregarded Entity
RI = Resident Individual
C
= C Corporation
B = Bank/Financial Institution
I
= Insurance Company
L
= LLC taxed as a Partnership
NR = Nonresident Individual
PI = Part-year Resident Individual (S Corp Only)
P
= Partnership
LC = LLC taxed as a C Corporation
E
= Estate
T = Trust
S
= S Corporation
LS = LLC taxed as an S Corporation
X
= Exempt
9 DIGIT - NO DASH
1
Code
SSN/FEIN
Revenue ID
Ownership %
.
Name:
Address:
9 DIGIT - NO DASH
Code
SSN/FEIN
Revenue ID
Ownership %
2
.
Name:
Address:
9 DIGIT - NO DASH
3
Code
SSN/FEIN
Revenue ID
Ownership %
.
Name:
Address:
9 DIGIT - NO DASH
Code
SSN/FEIN
Revenue ID
Ownership %
4
.
Name:
Address:
9 DIGIT - NO DASH
5
Code
SSN/FEIN
Revenue ID
Ownership %
.
Name:
Address:
9 DIGIT - NO DASH
6
Code
SSN/FEIN
Revenue ID
Ownership %
.
Name:
Address:
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1307610053
1307610053

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