RCT-127 A (11-13) (FI)
1271013105
PAGE 1 of 7
No dashes (-) or slashes (/) to be used in any fields, this includes Date, FEIN, Phone and ZIP
PUBLIC UTILITY REALTY TAX REPORT
2013
Bureau of Corporation Taxes
PO BOX 280704
Harrisburg PA 17128-0704
REVENUE ID
START
NAME
(Department Use Only)
Date Received
OFFICIAL USE ONLY
ADDRESS
FEDERAL ID (FEIN)
CITY
STATE
ZIP
o
o
Check to indicate a change of address
Check to send all correspondence to preparer.
o
o
First Report
Last Report (Out-of-Existence as of ___________________.)
ANNUAL PAYMENTS
TAX YEAR ENDING
DUE DATE
12/31/13
05/01/14
USE WHOLE DOLLARS ONLY (NO EXTENSIONS)
REVENUE USE ONLY
Estimated
TAX TYPE
Payments & Credits
Remittance
on Deposit
TAX TYPE CODE
PUBLIC UTILITY REALTY TAX
1020
GRAND TOTALS
o
NO REAL PROPERTY CLASSIFIED AS PURTA PROPERTY WAS OWNED AS OF DEC. 31, 2013. NO TAX DUE.
A public utility is responsible for all of its PURTA property being properly reported by each county, including correct parcel number, name and mailing address.
If the county is not reporting this information correctly, it is the utility’s responsibility to make all corrections with the county.
I affirm under penalties prescribed by law, this report, including any accompanying schedules and statements, has been examined by me and to the best of my knowledge and belief
is a true, correct and complete report. This declaration is based on all information of which I have any knowledge.
Signature of Officer
Title
Date
Telephone Number
Signature of Officer – Please sign after printing
PRINT Name of Officer
Email Address of Officer
I affirm under penalties prescribed by law, this report, including any accompanying schedules and statements, has been prepared by me and to the best of my knowledge and belief is a
true, correct and complete report.
PRINT Individual Preparer or Firm’s Name
Signature of Preparer
Fax Number
Signature of Preparer – Please sign after printing
PRINT Individual Preparer or Firm’s Street Address
Title
Telephone Number
City
State ZIP
Email Address
Date
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