v5.0
Pennsylvania Department of Revenue
Please complete the following information:
- The top section regarding your business information
- Attorney-In-Fact Name: Payroll Center Inc
- Attorney-In-Fact Mailing Address: 2300 Lake Park Drive Ste 270 Smyrna, GA 30080
- Please place a check next to box 1: Office of Unemployment Compensation Tax Services
- The employer will need to sign at the bottom of the form
- This form will need to be signed by a notary public and have a notary seal
Pennsylvania Unemployment Compensation
Please complete the following information:
- The top section regarding your business information
- The employer will need to sign at the bottom of the form
If you have any questions please call (877)-328-6505, and ask for Tax and Compliance. You may also create a ticket by selecting "Submit a Request" at the top of this page.
You may send completed power of attorney forms via fax, scan and email the forms, or submit the forms through a help desk ticket by following the steps above.
**Please complete and fax/scan/email a completed power of attorney form for each state that your company currently has a tax obligation for. Ex: If you are located in both Alabama and Georgia, please completed and return a power of attorney for each state.**