Form Rev-563 - Responsible Party Information Form Page 2

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INSTRUCTIONS FOR COMPLETING THE
RESPONSIBLE PARTY INFORMATION FORM (REV-563)
GENERAL INFORMATION
SECTION II.
Enter the responsible party name, Social Security Number
Responsible parties, for the purpose of PA trust fund taxes, are
(SSN), home address (a P.O. BOX is not acceptable), title,
persons or officers who have active control or authority over a
daytime telephone number, effective date and end date. This
business or organization, and/or persons who have direct
section must be signed by each responsible party.
control over finances, and are therefore liable for the payment
of any trust fund tax liabilities.
SIGN AND DATE THE FORM.
Include the telephone number and title.
Questions may be
An individual who signs an application or trust fund tax return
directed to the Taxpayer Service and Information Center at
for a business or organization will be considered a responsible
717-787-1064; Service for taxpayers with special hearing
party in the absence of any contradicting evidence.
and/or speaking needs is available by calling
Personal representatives of a decedent’s estate, bankruptcy-
1-800-447-3020 (TT only).
insolvency trustees and lenders that have assumed direct
REGISTRATION METHODS
control over the borrowers’ finances may be considered
A new PA-100 Enterprise Registration form can be completed
responsible parties for PA trust fund tax purposes. Businesses
online by visiting To obtain
or organizations making changes to responsible parties are
a paper registration form and instructions call our forms
required to complete and file a REV-563 with the department.
ordering service at 1-800-362-2050.
SECTION I.
Enter the legal name of the business, Account ID Number and
MAIL TO:
PA Department of Revenue
Entity ID (federal EIN).
PO BOX 280901
Harrisburg, PA 17128-0901
RETURN TO PAGE ONE
RESET FORM
PRINT

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