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Get PA REV-679 2020-2021

Form must match what you provide on your electronically filed Other Tobacco Products Tax Return found at www.etides.state.pa.us Check here for Ammended Report Account Number Period (MM/YY - MM/YY) Wholesaler FEIN Manufacturer Retailer SSN Due Date (MM/YY) Name or Business Name Street Address City State ZIP Code Please check the box if you have non-taxable purchases or sales during the reporting period. Appropriate schedules must accompany the REV-679 to support the untaxed sales/purc.

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