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Case File
efta-efta01219715DOJ Data Set 9Other

CUT ALONG DASHED LINES

Date
Unknown
Source
DOJ Data Set 9
Reference
efta-efta01219715
Pages
1
Persons
0
Integrity

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Extracted Text (OCR)

EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
CUT ALONG DASHED LINES r PA4O1 (743) • Intuit PA DEPARTMENT OF REVENUE EMPLOYER DEPOSIT STATEMENT OF WITHHOLDING TAX ENTITY ID (E IN) ACCOUNT ID INT RATE TAX RATE DEPOSIT PERIOD ENDING DUE DATE Only use black or blue ink. Do not use red Ink or pencil. Do Not Make Corrections To The PREPRINTED Information On This Form. Use The Change/Correction Form (REV-1705) DEPARTMENT USE ONLY If the payment Is remitted by EFT or credit card. do not Me this PA.501. L 1 TOTAL COMPENSATION SUBJECT TO PA TAX 2 PA WITHHOLDING TAX 3 LESS CREDITS 4 PLUS INTEREST PAYMENT DATE 00007 DAYTIME TELEPHONE/ EXT SIGNATURE TITLE EFTA01219715

Technical Artifacts (2)

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Email addresses, URLs, phone numbers, and other technical indicators extracted from this document.

SWIFT/BICEMPLOYER
SWIFT/BICWITHHOLDING

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