REV-181 (CM), Application for Tax Clearance Certificate (Pennsylvania Department of Revenue) Completed Form Examples and Samples
Explore detailed examples and samples of the REV-181 (CM), Application for Tax Clearance Certificate. This guide provides filled-out versions of the Pennsylvania Department of Revenue form for various scenarios like corporate dissolution, mergers, and business sales, helping you complete your application correctly.
REV-181 (CM) Example – Corporate Dissolution
How this form was filled:
This example shows how a corporation, Keystone Innovations Inc., fills out the REV-181 to obtain a tax clearance certificate for voluntary dissolution. It includes the corporation's identifying information, states the reason as 'Corporate Dissolution,' provides the date of business cessation, and is signed by a corporate officer. The request is being made on behalf of the corporation by its legal counsel.
Information used to fill out the document:
- Corporation Name: Keystone Innovations Inc.
- Federal EIN: 98-7654321
- PA Corporate Tax Account ID: 1234567-8
- Corporation Address: 456 Liberty Ave, Suite 200, Pittsburgh, PA 15222
- Reason for Request: Corporate Dissolution
- Date of Business Cessation: 01/31/2026
- Final Tax Return Filed Date: 03/15/2026
- Authorized Officer: Jane Smith
- Officer Title: President
- Application Date: 04/05/2026
- Requester: Robert Jones, Esq. (Jones & Associates Law Firm)
- Requester Address: 789 Grant Street, Pittsburgh, PA 15219
What this filled form sample shows:
- Clear identification of the business entity with Federal EIN and PA Corporate Tax Account ID.
- Specifies 'Corporate Dissolution' as the reason for the application.
- Includes the crucial date of cessation of business operations.
- Shows the form being signed by an authorized corporate officer and submitted by legal counsel.
Form specifications and details:
| Form: | REV-181 (CM), Application for Tax Clearance Certificate |
| Jurisdiction: | Pennsylvania Department of Revenue |
| Use Case: | Corporation seeking tax clearance for voluntary dissolution. |
Created: January 29, 2026 07:50 AM
