Rev 1605-2026

1. Download the rev 1605 form onto your computer before starting the completion process.
2. Open the downloaded form in our editor by clicking ‘Get Form’ to begin filling it out.
3. In Section I, enter your Business Name, EIN, Revenue ID, Department of State Entity Number, and complete the Street Address, City, State, and ZIP Code fields.
4. Move to Section II and provide the names of corporate officers. Fill in all required fields for each officer including Last Name, First Name, Middle Initial (MI), SSN, and their respective titles such as President or Vice President.
5. In Section III, ensure that an authorized officer or representative completes the affirmation statement. They must sign and date the form.
6. Once completed, submit the signed form via fax at 717-787-3708 or email it to RA-BTFTREGISFAX@PA.GOV.

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