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Rev 1176

Rev 1176-2026

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The document is an 'E-TIDES Administrative Access Change Request Form' used to reassign or request administrative access for e-TIDES, a tax filing system. It outlines the registration process for new users, details required information for changing access, and specifies that a Power of Attorney form or written authorization is needed. Contact information and submission instructions are also provided.

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Click ‘Get Form’ to open rev 1176 in the editor.
Begin with SECTION I. Fill in the EIN and Business Name fields accurately. Indicate your relationship to the business and check all applicable tax types, providing the corresponding account numbers.
Move to SECTION II. Enter the User ID of the registered individual along with their email address and business name for verification.
In SECTION III, provide your telephone number, title, and ensure you sign and date the form. Remember to print it before signing.
Once completed, utilize our platform's email feature to send the form to ra-btftebusiness@pa.gov or fax it to 717-787-0145 for submission.

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