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(Department Use Only) DAN RCT123 (1206) 12300061014 ACCOUNT ID (CORPORATE BOX NUMBER) Commonwealth of Pennsylvania GROSS PREMIUM TAX PA Department of Revenue PO BOX 280407 Harrisburg, PA 171280407
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Department use only refers to information or sections on a form that are for internal use of the department and should not be filled out by the applicant or individual completing the form.
Department use only is typically filled out by employees or representatives of the department or organization collecting the form.
Department use only sections are typically filled out by authorized individuals within the department using the information provided by the applicant or individual completing the form.
The purpose of department use only is to keep certain information confidential or internal to the department, and to ensure that only authorized individuals have access to that information.
The information reported on department use only sections may vary depending on the form or document, but typically includes sensitive or confidential information that should not be disclosed to the public.
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