Business/Account Cancellation Form (REV-1706)
REV-1706 (TR) 03-17
buSINESS/ACCOuNTCANCELLATIONfORm
LEGALNAmE: TRADENAmE:
ENTITyID(EIN/SSN):
SECTIONI.
STATE/LOCALSALESTAxLICENSECANCELLATIONINfORmATION SalesTaxLicenseisNon?Transferable
SAlES TAX ACCOUNT iD
o o BUSiNESS DiSCONTiNUED
NO TAXABlE SAlES FOR: MM/DD/YY
REPORTiNG AND PAYiNG UNDER ANOTHER ACCOUNT iD NUMBER:
OTHER REASONS:
o STATE/lOCAl TAX AFTER o PHilADElPHiA lOCAl TAX AFTER o AllEGHENY COUNTY lOCAl TAX AFTER
DATE DATE DATE
STATE/lOCAl TAX ACCOUNT iD
o STATE/LOCAL TAX o PHILADELPHIA LOCAL TAX o ALLEGHENY COUNTY LOCAL TAX
SECTIONII. EmpLOyERwIThhOLDINGTAxCANCELLATIONINfORmATION
EMPlOYER wiTHHOlDiNG TAX ACCOUNT iD
REASON FOR FiNAl CANCEllATiON:
o BUSiNESS ClOSED OR SOlD o NO lONGER HAS EMPlOYEE(S) SUBjECT TO PA PERSONAl iNCOME TAX o OTHER
DATE DATE DATE
MM/DD/YY
REPORTiNG AND PAYiNG UNDER ANOTHER ACCOUNT iD NUMBER:
EMPlOYER wiTHHOlDiNG TAX
ACCOUNT iD
SECTIONIII. pubLICTRANSpORTATIONASSISTANCEfuNDTAxESANDfEES/VEhICLERENTALTAxINfORmATION pTALicenseisNon?Transferable
PTA TAX ACCOUNT iD
BUSiNESS DiSCONTiNUED
REPORTiNG AND PAYiNG UNDER ANOTHER ACCOUNT iD NUMBER:
VEHiClE RENTAl TAX iNFORMATiON:
DATE
MM/DD/YY
PTA TAX ACCOUNT iD VRT ACCOUNT iD
SAlES TAX ACCOUNT iD BUSiNESS DiSCONTiNUED DATE
MM/DD/YY
SECTIONIV.CIGARETTEDEALER'SLICENSECANCELLATIONINfORmATION CigaretteDealer'sLicenseisNon-Transferable
CiGARETTE DEAlER'S liCENSE NUMBER
NAME
SSN
FAX OR EMAil TO: FAX: 717-787-3708 EMAil: RA-BTFTREGiSFAX@
Reset Entire Form
DATE MM/DD/YY
DAYTiME TElEPHONE
EXT. SiGNATURE/TiTlE
PLEASE SIGN AFTER PRINTING
EMAil ADDRESS
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InstRuctIons foR complEtIng thE BusInEss/account cancEllatIon foRm (REV-1706)
This form must be completed if the business was discontinued, sold or ceased operations in Pennsylvania. e-TIDES users may make changes directly to their accounts at etides.state.pa.usbyusingthe"Enterprisemaintenance"function. This form should be used for state/local sales/use tax, employer withholding tax, Public Transportation Assistance Fund taxes and fees, vehicle rental tax and cigarette dealer's licenses. when using this form for multiple taxes, the Account iD Numbers for the corresponding taxes must be entered.
SECTIONI.STATE/LOCALSALESTAx pENNSyLVANIA - Complete this section to cancel a state sales tax license when a business: - was discontinued, sold or ceased operations in Pennsylvania; - No longer makes taxable sales, rentals or leases; - No longer provides taxable services in Pennsylvania; or - Reports and pays under another Account iD Number.
LOCAL- Complete this section to advise the department that a business: - was discontinued, sold or ceased operations in Pennsylvania; - No longer makes sales, rentals or leases, or provides taxable sales or services subject
to local sales tax; - No longer reports use tax on property used or services provided within Philadelphia or
Allegheny County on which no local sales tax was paid; or - Reports and pays under another Account iD Number.
SECTIONII. EmpLOyERwIThhOLDING. if the business was sold, closed or no longer has employee(s) subject to PA personal income tax, complete this section. Provide the reason for the
cancellation and the required cancellation dates on this form. IftheEINischangedby theInternalRevenueService,anewregistration(pA-100)mustbecompleted.
SECTIONIII. pubLICTRANSpORTATIONASSISTANCE(pTA)fuNDTAxES&fEES/VEhICLERENTAL TAx(VRT). if the business no longer has sales, rentals or leases subject to PTA/VRT taxes and fees, or the sales tax license was cancelled, indicate business-discontinued date on the form. if the business reports under another Account iD Number, indicate the new Account iD Number on the form.
SECTIONIV. CIGARETTEDEALER'SLICENSE if cigarettes are no longer sold or if the sales tax license was cancelled, complete this information and indicate the date the business ceased selling cigarettes.
SIGNANDDATEThEfORm include a daytime telephone number, title and email. Fax or Email the completed form to: Fax: 717-787-3708 Email: RA-BTFTREGiSFAX@
REGISTRATIONmEThODS To obtain a PA Enterprise Registration Form, PA-100, visit pa100.state.pa.us or call the department's Forms Ordering Service at 1-800-362-2050. Service for Taxpayers with Special Hearing and/or Speaking Needs 1-800-447-3020 (TT only).
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