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State Telephone Date Zip MEDICAL HISTORYFORMName Home Phone Address Cell Phone City Zip Code DL#Date of BirthStateSexMF Ages#Email Address Patients Employer OccupationEmployers AddressWork Phonetic
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Contact US - Pennsylvania is a form used by taxpayers to communicate with the Pennsylvania Department of Revenue, typically regarding tax-related inquiries or issues.
Individuals, businesses, or entities that have questions or need to address issues related to their tax obligations in Pennsylvania are required to file the Contact Us form.
To fill out the Contact Us form, provide the required personal details such as name, address, tax identification number, and clearly state your inquiry or issue.
The purpose of Contact Us - Pennsylvania is to facilitate communication between taxpayers and the Department of Revenue for resolving tax-related questions or issues.
Information that must be reported includes taxpayer's name, address, contact information, tax identification number, and a detailed description of the inquiry or issue.
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