Instructions For Form Rev-853 - Pa Corporation Taxes Annual Extension Request Coupon

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INSTRUCTIONS FOR REV-853
PA CORPORATION TAXES ANNUAL EXTENSION REQUEST COUPON
1. Do not use this coupon if electronically submitting an extension request with payment.
2. Enter account information including file period begin, file period end, Tax Account ID, corporation
name, complete mailing address, state of incorporation and EIN.
3. Enter payments required for capital stock/foreign franchise (CS/FF), loans and corporate net income
(CNI) taxes. Also enter total payment. If no payment is being made for a tax, enter zero. You must
timely file REV-853 in order to receive an extension, even if you are not making a payment. A six-month
extension may be approved by PA if the taxpayer received the corresponding federal extension.
4. Signature, title, date, email address and telephone number should be provided by a
representative of the corporation.
5. Make check payable to “PA Department of Revenue” equal to the total payment on Line 4. Mail the
check and coupon to:
PA DEPARTMENT OF REVENUE
PO BOX 280425
HARRISBURG PA 17128-0425
6. For information on electronic filing options, visit the e-Services Center at
DO NOT USE DASHES (-) OR SLASHES (/) IN ANY FIELDS. ENTER DATE AS MMDDYYYY.
PLEASE READ THE INSTRUCTIONS BEFORE COMPLETING THIS COUPON.
✁
DETACH HERE BEFORE MAILING
REV-853 CT (11-11)
DEPT USE ONLY
PA CORPORATION TAXES
REV-853 ANNUAL EXTENSION REQUEST
BUREAU OF CORPORATION TAXES
FILE PERIOD BEGIN
FILE PERIOD END
TAX ACCOUNT ID
1. CS/FF TAX PAYMENT
.00
CORPORATION NAME
2. LOANS TAX PAYMENT
.00
STATE OF INCORPORATION
EIN
3. CNI TAX PAYMENT
ADDRESS
.00
STREET
4. TOTAL PAYMENT
$
.00
0
(Add Lines 1, 2 and 3.)
CITY
STATE
ZIP
Make checks payable to “PA DEPT OF REVENUE.”
PRINT
RESET
SIGNATURE
TITLE
DATE
EMAIL
TELEPHONE
Please sign after printing.

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