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Get PA DoR REV-545 2016

START ENTITY NAME FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN) REVENUE ID/SSN STREET ADDRESS DUE DATE: SEPT. 15, 2016 DEPARTMENT USE ONLY POST MARK DATE: CITY OR TOWN, STATE AND ZIP CODE CHECK BOX IF A SMALL BUSINESS IF CLAIM IS AS A SMALL BUSINESS WITH TOTAL ASSETS OF LESS THAN $5 MILLION AT THE BEGINNING OR END OF THE YEAR, SUBMIT A BALANCE SHEET REFLECTING TOTAL ASSETS. ENTER ENTITY TYPE (SEE INSTRUCTIONS ON PAGE 3.) KOZ - SEE PAGE 2.

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