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Get PA REV-1667 R 2004

TE JANUARY 31 FOR TAPE REPORTING NUMBER OF TAPES DENSITY TRACKS PARITY BUSINESS NAME AND ADDRESS LEGAL NAME ANNUAL RECONCILIATION Wages paid subject to PA withholding tax PA tax withheld 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter TRADE NAME ADDRESS CITY STATE ZIP DO NOT SEND PAYMENT WITH THIS FORM. TOTAL Attach adding machine tape(s) or some acceptable listing of tax withheld as reported on accompanying paper W-2 form(s) to substantiate reported PA withholding tax.This tape.

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