Revenue Clearance Form for Tax Credit and Economic Development Programs

An Official Pennsylvania Government Website

Department of Revenue

Step 1 of 3

Program Name

If Other, Please Specify

Business Name

Business/Entity Type

First Name

Last Name

Tax Number Type

Tax Number

PA Revenue Number

Address Line 1

Address Line 2

City

State

Postal Code

Phone Number (XXXXXXXXXX)

Extension

Email Address

Application ID

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