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Get Pa Pa-8879 2004

Form PA-8879 Pennsylvania e-file Signature Authorization Declaration Control Number DCN Taxpayer s Name Social Security Number Spouse s Name Spouse s Social Security Number PART I Tax Return Information Tax Year Ending December 31 2004 Whole Dollars Only 1. Adjusted PA Taxable Income Form PA-40 line 11. 1. 2. PA Tax Liability Form PA-40 line 12. 2. 3. Total PA Tax Withheld Form PA-40 line 13. 3. 4. Refund Form PA-40 line 29. 4. 5. Total Payment Tax Due Form PA-40 line 27. 5. PART II Declaration .

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