IMPORTANT: FILL IN FORM MUST BE DOWNLOADED ONTO YOUR COMPUTER PRIOR TO COMPLETING

                                         (TR+) 10-23
                                                                                                  OFFICIAL USE ONLY
                     REV-1705R 
                                                           TAX ACCOUNT INFORMATION 
                                                      CHANGE/CORRECTION FORM

        If your FEIN was changed by the IRS, you must complete the Pennsylvania Online Business Tax Registration at mypath.pa.gov.  
                     SALES/USE TAX, PTA, VRT, AND CIGARETTE DEALER’S LICENSES ARE NON-TRANSFERABLE. 
SECTION I            ACCOUNT INFORMATION
 Existing Account/License ID  Entity ID (FEIN/SSN)                            Correct Entity ID (FEIN/SSN)       Current Filing Status

 Change Filing Status To: (Check only one - more frequent filing status only)
 Sales:     Monthly          Quarterly                                        Employer: Semimonthly             Semiweekly                  Monthly

SECTION II           EXISTING AND NEW LEGAL/TRADE NAME INFORMATION
 Existing Legal Name                                                          New Legal Name

 Existing Trade Name                                                          New Trade Name

 Existing Primary Address                                                     New Primary Address

 City                                                       State  ZIP Code  City                                                     State  ZIP Code

 Existing Location Address (No P.O. Box)                                      New Location Address (No P.O. Box)

 City                                                       State  ZIP Code  City                                                     State  ZIP Code

 Existing Mailing Address                                                     New Mailing Address 

 City                                                       State  ZIP Code  City                                                     State  ZIP Code

SECTION III          ADD LOCAL SALES TAX

      Allegheny County        Date of First Sale in County                        Philadelphia County    Date of First Sale in County
SECTION IV           OTHER TAX CHANGES
 Type of Tax
      Sales/Use Tax     Account/License ID Number:                                VRT                     Account/License ID Number:
      Employer Tax       Account/License ID Number:                               Tobacco               Account/License ID Number:
      PTA Tax               Account/License ID Number:

SECTION V            CERTIFICATION
Individual owner(s), partner(s), or corporate officer(s) responsible for return information. Ownership change requires a new registration.
 Name                                                       SSN               Name                                                    SSN

 Email                                                                                                      Daytime Telephone Number

 Signature                                                                               Title                                        Date
                             SIGN AFTER PRINTING

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                                                                Instructions for REV-1705R 
REV-1705R IN (TR+) 10-23                                        Tax Account Information Change/Correction  

GENERAL INFORMATION                                                               SECTION IV
This form is to be used to report Entity ID (FEIN/SSN),         OTHER TAX CHANGES 
business name, address corrections, a change to a more          If changing information for other taxes, check the appropiate 
frequent filing status, and/or to register to collect and remit box and enter the corresponding Account ID, License ID, or 
local sales tax.  This form may also be used to                 Withholding ID Number(s). 
change/correct information for other business taxes. 
Sales/use tax, PTA, VRT, and tobacco licenses are non-                                                             
                                                                                  SECTION V
transferable. myPATH users may make changes directly to 
their accounts by logging in to myPATH at mypath.pa.gov.        CERTIFICATION 
                                                                If there are changes to the individual owner(s), partner(s), 
                                                             
LINE INSTRUCTIONS                                               or corporate officer(s) responsible for return information, 
                                                                complete this section. 
                                                             
                         SECTION I                              If the owner(s), partner(s), or corporate officer(s) 
ACCOUNT INFORAMTION                                             changed as a result of the restructure of a business 
                                                                (e.g., incorporation or a change in ownership), a new 
Enter your eleven-digit Account ID, eight-digit License ID, or 
                                                                registration form must be completed to obtain a new 
eight-digit Withholding ID Number. Update your FEIN if it has 
                                                                account ID number(s). 
been changed by the Internal Revenue Service.  The 
Pennsylvania Online Business Tax Registration must be           SIGN AND DATE THE FORM 
completed if you have received a new FEIN. To change to a       Include a daytime telephone number and title. Fax or Email 
more frequent filing status, check the appropriate block for    the completed form to: 
sales tax or employer withholding. A change in filing status 
                                                                Fax: 717-787-3708 
will be effective only at the beginning of a filing period. 
                                                                Email: ra-btftregisfax@pa.gov 
                                                             
               SECTION II                                       REGISTRATION METHODS 
EXISTING AND NEW                                                To register, complete the Pennsylvania Business  Tax 
LEGAL TRADE NAME INFORAMTION                                    Registration available on myPATH at mypath.pa.gov.
Complete this section if your legal and/or trade name 
changed or if correcting an error. However, if your legal 
and/or trade name changed as a result of a business 
reorganization (e.g., incorporation or a change in 
ownership), a new  Pennsylvania Online Business  Tax 
Registration must be completed. If the Primary, Location, 
and/or Mailing Address changed, complete this section.      A 
Post Office Box is not acceptable for a physical location. 
                                                             
               SECTION III
ADD LOCAL SALES TAX 
If a business opens a new location in Allegheny and/or 
Philadelphia county(ies), and it does not currently report the 
local sales tax for that/these county(ies), complete this 
section. Enter the date(s) of the first sale from either one or 
both counties, if applicable. 

www.revenue.pa.gov                                                                                  REV-1705R     1
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