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Get and Sign Pennsylvania Petition Form 2000
NUMBER
)
(
NAME OF REPRESENTATIVE
)
REPRESENTATIVE INDEX NUMBER (If known)
STREET ADDRESS
CITY
COUNTY
STATE
TELEPHONE NUMBER
(
4
)
TELEPHONE NUMBER
)
(
TYPE OF TAX INVOLVED
TAX PERIOD
TAXPAYER IDENTIFICATION NUMBER
)
FROM
TO
ASSESSMENT/REDETERMINATION NUMBER
Review of Resettlement / Reassessment Petition
Review of Refund Petition
Refund Petition If refund, please indicate:
CASH or
5
ZIP CODE +4
CONTACT PERSON
FAX NUMBER
(
COUNTRY
CREDIT
AMOUNT:...
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