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Get PA Form PA-40 ES (I) 2019

BLE TO PA DEPARTMENT OF REVENUE - YOU MUST INCLUDE THE LAST 4 DIGITS OF SSN AND THE FULL NAME OF THE PRIMARY TAXPAYER ON YOUR CHECK OR MONEY ORDER LAST NAME Y Y DATE FILED FISCAL FILERS ONLY READ INSTRUCTIONS BEFORE ENTERING DOLLAR AMOUNTS. DAYTIME TELEPHONE NUMBER - M M M D D Y Y Y Y M M D D Y Y Y Y BEGINNING ENDING MAIL THIS FORM WITH YOUR PAYMENT TO: PA DEPARTMENT OF REVENUE PO BOX 280403 HARRISBURG PA 17128-0403 FIRST NAME TYPE OF ACCOUNT: P.O. BOX, APT. NO.

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