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                                 (SU) 02-24 (FI)
                   REV-774 
                                                      CORPORATION TAX PAYMENT/ 
                                                          OVERPAYMENT CREDIT

      This notice is to authorize the movement of Corporation tax payment/overpayment credit(s). DO NOT SUBMIT WITH TAX REPORT
 From Assignor (holder of the payment/overpayment credit):
START Name of Owner (Individual, Partnership, Corporation, etc.)                                                                           Federal Employer Identification Number (FEIN) 
Ü
 Trade Name (If other than preceding line)                                                                                                      Type of Tax (Sales, Corporation, etc.) 

 Street Address                                                             City                                       State        ZIP                 Revenue ID Number

      TYPE OF TAX AND IDENTIFICATION NUMBER               MONTH/YEAR OR TAX NOTICE NUMBER                                                            AMOUNT TO BE CREDITED

 To Assignee (receiver of payment/overpayment credit):
 Name of Owner (Individual, Partnership, Corporation, etc.)                                                                           Federal Employer Identification Number (FEIN) 

 Trade Name (If other than preceding line)                                                                                                      Type of Tax (Sales, Corporation, etc.) 

 Street Address                                                             City                                       State        ZIP                 Revenue ID Number

      TYPE OF TAX AND IDENTIFICATION NUMBER               MONTH/YEAR OR TAX NOTICE NUMBER                                                            AMOUNT TO BE CREDITED

 For value received, the above-named assignor sells, transfers and assigns to the assignee, the payment/overpayment credit(s) listed above.
                   DAY                          MONTH, YYYY
 Signed this                                                day of                                                        . 
 If Proprietorship or Partnership:                                                                         If Corporation: 
 Signature                                                                                                            Signature of Corporate Officer 
                   Please Sign after printing.                                                                                      Please Sign after printing.
 Signature                                                                                                            Officer Title 
                   Please Sign after printing.
 Telephone Number                                                                                             Telephone Number

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                                                                Instructions for Form REV-774 
REV-774 IN (SU) 02-24                                                Corporation Tax Payment/Overpayment Credit

                                                                     Assignments/Transfers will be applied as of the date of the   
GENERAL INFORMATION                                                  payment that created the payment/overpayment credit. 

Do not submit this form for the sale or reassignment of              In the case of a partnership assigning credit, the signatures of 
Restricted Tax Credits. Tax questions on restricted credits          all partners are required (attach a separate schedule if necessary). 
previously awarded within the program or credits obtained via sale 
or assignment may be directed to the Department of Revenue at        For corporations, the signature of a corporate officer is required. 
717-772-3896 or ra-rvtaxcredits@pa.gov .
                                                                     For more information, email  RA-CORP_ACC_FAX@PA.GOV. 
Assignments are the transfer of available payment/overpayment 
credit between business entities. Credit is available for assignment Submit forms to RA-CORP_ACC_FAX@PA.GOV. 
to the extent that the credit exceeds the debits owed the 
commonwealth by the assignor. The application for assignment         NOTE: DO NOT SUBMIT WITH TAX REPORT
authorizes the Department of Revenue to transfer available credit 
as an offset to debits within the account releasing the credit. 

Payment/Overpayment Credits may be used as payment of any 
commonwealth tax obligation administered by the Department of 
Revenue other than a Motor License Fund obligation. 

www.revenue.pa.gov                                                                                                REV-774 1
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