15 134B Form PDF Details

The 15 134B form is a document used to claim a refund of excess social security and medicare taxes withheld from an employee's wages. The form must be filed within three years of the date the tax was withheld. In order to claim the refund, the taxpayer must have paid more in social security and medicare taxes than were legally due. There are several steps that must be followed in order to file a successful Claim for Refund of Excess Social Security and Medicare Tax Withheld (Form 15 134B). The most important step is to gather all required documentation, including W-2s and proof of payment for any additional taxes that were paid. The form can be filled out electronically or by hand, but it is important to

QuestionAnswer
Form Name15 134B Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other names134 b form, 15 134b, dscb 15 134b, docketing statement 15

Form Preview Example

Docketing Statement (Changes) DSCB:15-134B

Part I. Complete for each filing:

BUREAU USE ONLY:

 

 

 

Revenue

 

 

Labor & Industry

 

 

 

 

 

 

 

 

 

Other _____________________

 

 

 

 

File Code_________ Filed Date ____________

 

Current name of entity or registrant (survivor or new entity if merger or consolidation):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Entity number, if known:

 

 

 

Incorporation/qualification date in PA:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State of Inc:

 

 

Federal EIN:

 

 

Specified effective date, if any:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Part II. Check proper box:

 

 

Amendment (complete Section A)

 

 

 

Merger, Consolidation or Division (complete Section B,C or D)

 

 

 

Consolidation (complete Section C)

 

 

 

 

 

Division (complete Section D)

 

 

 

Conversion (complete Section A & E)

 

 

 

 

 

Correction (complete Section A)

 

 

 

Termination (complete Section H)

 

 

 

 

 

Revival (complete Section G)

 

 

 

Dissolution before Commencement of Business (complete Section F)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section A Check box(es) which pertain to changes:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Registered Office: Number & street/RD number & box number City

State

 

Zip

County

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Purpose:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Stock (aggregate number of share authorized):

 

Effective date:

.

 

 

 

 

 

 

 

 

Term of Existence:

 

 

 

 

 

Other:

 

 

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section B Merger Complete Section A if any changes to surviving entity:

 

 

 

 

 

 

 

 

 

Merging Entities are: (attach sheet for additional merging entities)

 

 

 

 

 

 

 

 

 

 

DSCB:15-134B-2

 

 

 

 

 

 

 

Entity #, if known:

 

Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DSCB:15-134B-2

Inc./qual. date in PA.

 

 

 

 

 

State of Inc.

 

 

 

Effective date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name:

 

 

 

 

 

 

 

Entity #, if known:

 

 

 

 

 

 

 

 

 

 

 

 

Effective date:

Inc./qual. date in PA.

 

 

 

 

 

State of Inc.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section C - Consolidation

Consolidating Entities are: (attach sheet for additional consolidating entities)

Name:

Entity #, if known:

Inc./qual. date in PA.

State of Inc.

 

 

 

Name:

Entity #, if known:

Inc./qual. date in PA.

State of Inc.

 

 

 

Section D – Division

Forming new entity(s) named below: (attached sheet for additional entities)

Name:

 

Entity Number:

 

 

 

Name:

 

Entity Number:

 

 

 

Check one:

 

Entity named in Part I survives. (any changes, complete Section A)

 

 

Entity named in Part I does not survive.

Section E – Conversion (complete Section A)

Check one:

 

Converted from nonprofit to profit

 

Converted from profit to nonprofit

Section F – Dissolved by Shareholders or Incorporators Before Commencement of Business

Section G – Statement of Revival (complete Section A for any changes to revived entity)

Entity named in Part I hereby revives its charter or articles which were forfeited by Proclamation or expired.

Section H – Statement of Termination (attach sheet for additional entities involved)

 

 

filed in the Department of State on

 

 

is/are hereby terminated.

(type of filing made)

month/date/year

hour, if any

 

If merger, consolidation or division, list all entities involved, other than that listed in Part I:

Name:

 

 

 

Entity number:

 

 

 

 

 

Name:

 

 

 

Entity number:

 

 

 

 

 

 

 

How to Edit 15 134B Form Online for Free

With the online PDF tool by FormsPal, it is easy to fill out or alter pa dept of state dscb 15 134b right here. FormsPal team is constantly endeavoring to improve the tool and ensure it is even faster for people with its extensive features. Take advantage of today's progressive possibilities, and find a heap of emerging experiences! Starting is easy! All that you should do is adhere to the following basic steps directly below:

Step 1: Hit the "Get Form" button at the top of this page to access our PDF tool.

Step 2: With the help of this advanced PDF editing tool, it is possible to accomplish more than simply complete blank form fields. Try all of the functions and make your documents appear professional with customized text added in, or fine-tune the file's original input to excellence - all comes with the capability to insert any type of graphics and sign the document off.

As for the blanks of this precise document, here is what you should consider:

1. The pa dept of state dscb 15 134b requires specific details to be inserted. Ensure the following blanks are complete:

134 b form list conclusion process shown (part 1)

2. Once your current task is complete, take the next step – fill out all of these fields - Docketing Statement Changes DSCBB, Purpose, Section A Check boxes which, Registered Office Number streetRD, Stock aggregate number of share, Section B Merger Complete Section, Effective date Incqual date in PA, and Name Entity if known with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Completing segment 2 in 134 b form list

Those who work with this PDF generally get some things wrong when completing Section B Merger Complete Section in this part. Ensure that you go over everything you enter here.

3. Completing Docketing Statement Changes DSCBB, Name Entity if known, and Effective date Incqual date in PA is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

Name Entity  if known, Effective date Incqual date in PA, and Docketing Statement Changes DSCBB inside 134 b form list

4. The next section requires your details in the following areas: Section C Consolidation, Entity if known Incqual date in, Name, Entity if known Incqual date in, Section D Division Forming new, and Name Entity Number. It is important to fill in all needed information to go further.

Tips on how to fill in 134 b form list part 4

5. To wrap up your document, this final part includes several additional blank fields. Entering Name Entity Number, Check one Entity named in Part I, Section E Conversion complete, Section F Dissolved by, Section G Statement of Revival, and Section H Statement of will wrap up the process and you're going to be done very fast!

Completing segment 5 of 134 b form list

Step 3: When you have reviewed the details in the document, click "Done" to conclude your document creation. After registering afree trial account with us, you'll be able to download pa dept of state dscb 15 134b or email it promptly. The PDF form will also be available through your personal account menu with all your adjustments. FormsPal guarantees your data privacy with a secure system that in no way records or distributes any private information typed in. You can relax knowing your files are kept confidential whenever you work with our service!