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the information for each estimated payment. The total amount
HOW TO FILE
that should remain in the account should be shown in the
Remain In Account column, and the total amount to be The completed and signed form(s) may be mailed, emailed
transferred to the spouse’s account should be shown in the or faxed to the department prior to filing the return(s), or the
Transfer To Account column, along with all appropriate
information may be sent in with completed paper or e-filed
information.
returns. If the return(s) are e-filed, the completed form may
be included or attached as a pdf file to the return, or if the
SECTION III
software being used does not support the form, the form
TAXPAYER’S SIGNATURE AND CONSENT may be mailed, emailed or faxed to the department.
If separate accounts are being transferred into one
MAILING INSTRUCTIONS
account, both taxpayers should sign. If a joint account is
being separated into two accounts, both taxpayers should Send in the completed form prior to the filing or place a
sign. If one of the taxpayers is deceased, the surviving completed and signed form in front of each paper return
spouse should sign in SECTION III, and SECTION IV must filed, and mail each return to the department at:
also be completed. If the form is being prepared on behalf PA DEPARTMENT OF REVENUE
of the taxpayers by a preparer, the preparer must sign in BUREAU OF INDIVIDUAL TAXES
SECTION IV.
PO BOX 280501
HARRISBURG PA 17128-0501
SECTION IV
EMAILING/FAXING INSTRUCTIONS
PREPARER’S, SURVIVING SPOUSE’S
OR EXECUTOR’S OATH If e-filing the return(s) and the software does not support the
e-filing of this form, email or fax a completed and signed form
If one of the taxpayers is deceased and the accounts are
being combined, the surviving spouse, preparer or the to the department.
executor may sign on behalf of the deceased taxpayer. If Email Address:
both of the taxpayers are deceased, the executor(s) of the RA-BITPITELFCORFAXES@PA.GOV
estate(s) or the preparer may sign on behalf of the deceased
taxpayers. If the form is being prepared on behalf of the Fax Number: 717-772-4193
taxpayers, the preparer must sign the form. If the preparer
IMPORTANT: If emailing or faxing this form, please
or executor signs on behalf of the taxpayers or on behalf of
complete and use the PA Form DEX-93, Personal
a deceased taxpayer(s), the preparer and executor must
print their name or include the company name and daytime Income Tax Correspondence Sheet.
telephone number.
2 REV-459B www.revenue.pa.gov
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