Tax Certificate Pa Rev 181 PDF Details

When it comes to the taxes that you owe, there are a few different ways that the state can collect what you owe. One way is through a tax lien, which is when the state takes ownership of your property until you settle your debt. Another way is through a tax certificate, which is when the state sells off your debt to investors. In this article, we'll take a closer look at tax certificate PA Rev 181 Form.

To look at a number of specific details with regards to the file you'll work with, here is the facts you may want to read before filling out the tax certificate pa rev 181.

QuestionAnswer
Form NameTax Certificate Pa Rev 181
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namespa rev 181 pdf, philadelphia tax clearance, rev181, rev 181 form pa

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REV-181 (CM) 02-21

Department Use Only

 

 

APPLICATION FOR TAX

 

 

 

 

 

Bureau of Compliance

CLEARANCE CERTIFICATE

Revenue id

 

 

 

 

 

PO BOX 280947

NO FILING FEE

 

Please Type or Print

 

 

Harrisburg PA 17128-0947

 

 

1

name of Business

 

 

Federal ein

 

 

 

 

 

 

 

 

2Location of Business (Current Mailing Address)

 

 

P.O. Box, Street and number or R.d. number and Box number

 

 

 

 

 

Telephone number

 

 

 

 

 

 

 

 

 

 

 

 

 

(

 

 

)

 

 

 

 

 

 

 

 

 

 

 

City or Town

 

 

 

County

 

 

State

 

 

ZiP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

name, Address and Phone number of Attorney or Representative to whom Clearance Certificate should be sent (if different from #2)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

name

 

 

 

 

 

 

 

 

 

Telephone number

 

 

 

 

 

 

 

 

 

 

 

 

 

(

 

 

)

 

 

 

 

 

 

 

 

 

 

 

P.O. Box, Street and number or R.d. number and Box number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City or Town

 

 

 

County

 

 

State

 

 

ZiP Code

 

 

 

 

 

 

 

 

 

 

 

 

4

name(s), Home Address(es) and Social Security number(s) of Sole Proprietor, General Partners, Business Trustee, President and Treasurer of

 

 

the Corporation or Chief executive Officer or Majority Owner of entity. (Attach listing if necessary.)

 

 

 

 

 

 

 

 

 

 

 

 

name

 

 

 

 

Social Security number

Telephone number

 

 

 

 

 

 

 

 

 

 

 

 

 

(

 

 

)

 

 

 

 

 

 

 

 

 

 

 

P.O. Box, Street and number or R.d. number and Box number

City

 

 

State

 

 

ZiP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

name

 

 

 

 

Social Security number

Telephone number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(

 

 

)

 

 

 

 

 

 

 

 

 

 

 

P.O. Box, Street and number or R.d. number and Box number

City

 

 

State

 

 

ZiP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

Type of Business

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

dOMeSTiC CORPORATiOn (incorporated in PA)

 

FOReiGn CORPORATiOn (not incorporated in PA)

nOnPROFiT CORPORATiOn

 

 

 

PARTneRSHiP

 

 

 

PROPRieTORSHiP

 

 

 

 

 

(Please submit copy of 501(c)

 

 

 

 

 

 

 

 

 

 

 

exemption letter)

 

 

 

ASSOCiATiOn

 

 

 

BuSineSS TRuST

 

 

 

 

 

LiquidATinG TRuST

 

 

 

LiMiTed LiABiLiTy PARTneRSHiP

 

 

 

OTHeR (Specify)

 

 

 

 

 

LiMiTed LiABiLiTy COMPAny

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

if domestic Corporation, give incorporation date.

if Foreign Corporation, give state where incorporated and date of Certificate of Authority in PA.

 

 

 

MM/DD/YYYY

 

 

 

 

 

 

 

 

 

 

 

 

MM/DD/YYYY

 

 

Registered Pennsylvania Address, P.O. Box, Street and number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City or Town

 

 

 

County

 

 

State

 

 

ZiP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

date business started in Pennsylvania

 

 

 

 

date terminated

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MM/DD/YYYY

 

 

 

 

 

 

 

 

 

MM/DD/YYYY

 

 

 

 

 

 

 

 

 

6

describe the business activity in Pennsylvania, including services performed and rendered, and give principal commodity sold at wholesale or

 

 

retail. if sales or construction are involved, please explain. if manufacturer’s representatives or independent contractors perform activities,

 

 

render services or execute sales on behalf of the entity rather than entity’s employees, please specify what activities were performed, what

 

 

services were rendered and what type of sales were executed.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

did the entity have employees for which PA personal income tax was required to be withheld from wages?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8

did taxpayer ever hold any of the following licenses, permits or accounts with the Commonwealth of PA? MM/DD/YYYY

 

 

(a)

Corporation Tax

yes

no

Period

 

 

to

 

 

 

 

Revenue id no.

 

 

 

 

 

 

 

 

 

 

 

 

(b)

Malt Beverage or Liquor License

yes

no

Period

 

 

to

 

 

 

 

License no.

 

 

 

 

 

 

 

 

 

 

 

 

(c)

Liquid Fuels

yes

no

Period

 

 

to

 

 

 

 

Permit

no.

 

 

 

 

 

 

 

 

 

 

 

 

(d)

Cigarette Tax

yes

no

Period

 

 

to

 

 

 

 

License no.

 

 

 

 

 

 

 

 

 

 

 

 

(e)

Sales, use and Hotel Occ. Tax

yes

no

Period

 

 

to

 

 

 

 

License no.

 

 

 

 

 

 

 

 

 

 

 

 

(f)

Motor Carrier

yes

no

Period

 

 

to

 

 

 

 

License no.

 

 

 

 

 

 

 

 

 

 

 

 

(g)

Fuel dealer-user

yes

no

Period

 

 

to

 

 

 

 

License no.

 

 

 

 

 

 

 

 

 

 

 

 

(h)

Lottery

yes

no

Period

 

 

to

 

 

 

 

Agent

no.

 

 

 

 

 

 

 

 

 

 

 

 

(i) Small Games of Chance Mfg. / distr.

yes

no

Period

 

 

to

 

 

 

 

License no.

 

 

 

 

 

 

 

 

 

 

 

 

(j)

Public Transportation Assistance

yes

no

Period

 

 

to

 

 

 

 

License no.

 

 

 

 

 

 

 

 

 

 

 

 

(k)

PA unemployment Compensation

yes

no

Period

 

 

to

 

 

 

 

Account no.

 

 

 

 

 

 

 

 

 

 

 

 

(l) PA Oil Company Franchise Tax

yes

no

Period

 

 

to

 

 

 

 

Account no.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Page 2

9Were the assets or activities of the business acquired in whole or in part from a prior business entity? Yes No ( If “Yes”, give predecessor’s name, address and acquisition date. )

 

Name

 

 

 

Acquisition Date

 

 

 

 

 

 

MM/DD/YYYY

 

 

P.O. Box, Street and Number

 

 

 

 

 

 

 

 

 

 

 

 

 

City or Town

County

State

 

ZIP Code

 

 

 

 

 

 

10

Has the business held title to any real estate in the last five years from the date of this application?

Yes

No

 

 

 

 

 

 

 

 

lIf “Yes”, complete Schedule A (last page).

lIf you currently hold title to real estate in PA, complete Schedule B (last page).

11

Will the assets or activities of the business be transferred to another?

 

 

 

If “Yes”, complete:

 

 

 

 

A.

Corporation

Yes

No

F. Other

Yes

No

 

 

 

Name of New Owner

 

 

 

 

 

 

 

 

 

B.

Partnership

Yes

No

Explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street Address of New Owner

 

 

C.

Proprietorship

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D.

Liquidating Trust

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

State

ZIP Code

 

 

E.

Association

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12Purpose of Clearance Certificate (check appropriate block):

A. Dissolution of Corporation or Association through Department of State.

B. Dissolution of Corporation or Association through Court of Common Pleas. Date Court was petitioned and county:

(date) MM/DD/YYYY(county)

C. Withdrawal of Foreign Corporation through Department of State

D. Merger or consolidation of two or more Corporations or Associations where surviving Corporation or Association is not subject to the

 

jurisdiction of Pennsylvania. (See 15 Pa C.S. § 139.)

 

 

 

E. Bulk Sale Clearance Certificate under Section 1403 of the Fiscal Code. Sale date:

 

MM/DD/YYYY

 

Copy of settlement statement:

 

 

 

 

 

 

 

Corporation Tax Purposes

 

Employer Withholding Tax Purposes

 

Sales, Use and Hotel Occupancy Tax Purposes

 

Unemployment Compensation Tax Purposes

 

 

 

 

 

 

STATEMENT OF AUTHORIZATION

I authorize the PA Department of Revenue to disclose, verbally or in written form, all tax filings, payments or delinquencies

requested by the buyer or his representatives for the bulk sale transfer provision.

 

MM/DD/YYYY

 

 

 

 

Authorized by

 

 

Title

Date

F. Foreign Corporation Clearance Certificate under the provisions of the Act of 1947, P.L. 493, Contract Number and Political Subdivision:

13Location of business records, available for audit of Pennsylvania operations.

P.O. Box, Street and Number

City

State

ZIP Code

 

 

 

 

Telephone Number

 

 

 

14List any matters pending with the PA Department of Revenue (e.g. petitions, appeals):

15

Did the business ever, within the Commonwealth of PA:

 

 

 

 

MM/DD/YYYY

 

 

(a)

........................................................Engage in the sale of soft drinks or soft drink syrup

Yes

No

Period

 

to

 

 

 

(b)

Own or lease and operate diesel-powered motor vehicles on PA highways?

Yes

No

Period

 

to

 

 

 

(c)

..........................Engage in the sale of diesel fuel to motor vehicles using PA highways?

Yes

No

Period

 

to

 

 

 

(d)

Engage in the sale or lease of tangible personal property since Sept. 1, 1953?

Yes

No

Period

 

to

 

 

 

(e)

File PA Unemployment Compensation Reports?

Yes

No

Period

 

to

 

 

 

If “Yes”, give Account Number

(See question 8k.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16Have you terminated your business activities in Pennsylvania? Yes No

l

If “Yes”, give distribution of assets date:

MM/DD/YYYY

 

 

l

If “No”, explain:

 

 

 

 

l

If a Foreign Corporation, have you terminated business in the state of your incorporation?

Yes No

 

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Page 3

17number of employees and total gross payrolls during the last five operating years (as reported to the Social Security Administration):

yeAR

TOTAL eMPLOyeeS

PA

TOTAL GROSS

 

PA

 

 

 

 

eMPLOyeeS

PAyROLL

 

GROSS PAyROLL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18Have the officers received any remuneration, in cash or other other form, for services performed in Pennsylvania during the current calendar year or during any of the preceding four calendar years?

yes no

19Were any remunerated services performed for the business in PA, which you believe did not constitute “employment” as defined in the PA unemployment Compensation Law? yes no

if “yes”, explain:

20A. Average number of stockholders during the last five years:

B.number of stockholders as of this report:

C.List names and home addresses of stock transfer agents who have handled the corporation’s stock:

name:Address:

 

 

d. Were all shares presented and property redeemed from any stock called for redemption or retired?

yes

no

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

21

 

The figures below must agree with the last corporate tax report filed with the PA department of Revenue.

 

 

 

 

 

 

date of Report:

MM/DD/YYYY

 

Total Liabilities:

 

 

 

 

 

 

 

 

Total Assets:

 

 

 

 

Total equity (net worth):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

22

 

A. List the amount of corporate bonds issued and still outstanding as of this report. Show each issue separately and include name and

 

 

 

address of any transfer or paying agents.

Agent

number of Outstanding Bonds

Amount

 

 

issue

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B. List names and addresses of transfer or paying agents not listed above who have handled corporate bond issues.

 

 

 

 

 

name:

 

 

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

23Have you consumed or used in Pennsylvania any tangible personal property or acquired such, after March 6, 1956, on which no PA sales or use tax was paid? if “yes”, please explain:

yes no

24do you have within your custody, possession or control any abandoned and unclaimed (escheatable) funds or assets such as dividends, payroll, deposits, outstanding checks, stock certificates, unidentified deposits, accounts payable debit balances, gift certificates, outstanding debentures or interest, royalties, mineral rights or funds due missing shareholders or other unclaimed amounts payable?

yes no

25Has the business filed a PA Abandoned and unclaimed Property Report for the preceding year? yes no

26CeRTiFiCATiOn: i certify that the information provided (including Schedules, if applicable) on this application has been examined by me and is, to the best of my knowledge, true and correct. (Certification must agree with individuals listed in question 4.)

Print name

 

Original Signature

Signature of Officer – Please sign after printing

Print name

 

Original Signature

Signature of Officer – Please sign after printing

This form will serve as an application for clearances from both the PA department of Revenue and PA department of Labor & industry.

nOTe: l Submit typed original to the PA department of Revenue (address on Page 1) and one copy to the PA dePARTMenT OF LABOR & induSTRy, OFFiCe OF uneMPLOyMenT COMPenSATiOn TAX SeRviCeS, e-GOveRnMenT uniT, LABOR & induSTRy BuiLdinG, ROOM 916, 651 BOAS ST., HARRiSBuRG PA 17121. Retain a copy for taxpayer’s record.

ldirect telephone inquiries to the PA department of Revenue at 717-783-6052 or at 717-346-2001. Services for taxpayer with special hearing /speaking needs can be accessed at 1-800-447-3020. Call the PA department of Labor & industry at 866-403-6163, Option 2 or 717-783-3545 for services for the hearing impaired.

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SCHEDULE A - STATEMENT OF ACQUISITION AND/OR DISPOSITION OF PENNSYLVANIA REAL ESTATE WITHIN FIVE YEARS FROM THE DATE OF THIS APPLICATION

Name of Transferee (EE) or Transferor (OR).

Indicate each by symbol EE or OR.

Date of Transfer

Property Location by

Local Political Subdivision

& County

Acquisition

Date

Original Cost

County

 

 

Land

Building

Assessed Value

 

 

 

Actual Consider-

Actual Monetary Worth

Amount of PA Realty

ation including

(Market Value)

Stamps Affixed to

Encumbrance

at Time of Transfer*

Document**

Assumed*

 

 

 

Explanation

SCHEDULE B STATEMENT OF ALL PENNSYLVANIA REAL ESTATE NOW OWNED

Property Location by Local Political Subdivision & County

Acquisition

Date

Original Cost

County

Actual Consider-

Actual Monetary Worth

Amount of PA Realty

 

 

ation including

(Market Value)

Stamps Affixed to

Land

Building

Assessed Value

Encumbrance

at Time of Transfer *

Document**

 

 

 

Assumed*

 

 

 

 

 

 

Explanation

List all real estate now owned in PA that the business will dispose of prior to or at the time of the action for which a clearance is required. If under agreement of disposition, attach copy of executed agreement for each property so affected.

*Complete if applicable. If transfer represents less than a full fee-simple interest in the property, explain on a separate sheet of paper. ** If no realty transfer tax was paid, explain on attached sheet or in “Explanation” column above.

If application is for a Bulk Sale Clearance Certificate, attach a list of PA properties that will be retained. For each property, provide the complete address, including county, date of acquisition and nature of property (residential, industrial, acreage, commercial or farmland). If none, state none.

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