Pennsylvania E-TIDES Administrative Access Change Request Form

E-TIDES Administrative Access Change Request Form
e-TIDES Administrative Access Change Request Form (REV-1176)
(SU) 07-20

REV-1176

OFFICIAL USE ONLY

E-TIDES
ADMINISTRATIVE ACCESS
CHANGE REQUEST FORM
This form is used to reassign e-TIDES Administrative Access to another person or to request access as an additional e-TIDES filer. When using this form
for multiple tax types, each tax account must be registered under the requester’s User ID and Password and listed below to have access granted. You
must complete the registration steps below before submitting this form.
TO REGISTER ON e-TIDES
First-time e-TIDES users must register at www.etides.state.pa.us, creating a User ID and Password.
STEP ONE
● Select “Enter e-TIDES”.
● Select “Register,” located at the bottom of the page.
● Select “I Agree” to the e-Signature Agreement to create your User ID and Password.
STEP TWO
● Select “Register Enterprise” from the left navigation.
● Choose your tax type and select “Next”.
● Select “I Agree” to the agreement.
● Enter your account number, Entity ID and type of Entity ID, then select “Next”.
● Select “Submit” to process your request to be added as a user on e-TIDES.
For additional information, please visit the department’s Online Customer Service Center at www.revenue.pa.gov or call the e-Business Tax Unit at
717-783-6277.

SECTION I
START

➜

CHANGE TAX ACCOUNT ADMINISTRATIVE ACCESS

This document must be accompanied by the REV-677, Power of Attorney and Declaration of Representative form, or written authorization on company’s
letterhead signed by both the owner and person requesting access.
This will remove access from the current administrator for this tax account.
Requesting access as an additional e-TIDES filer only.
EIN

Business Name

Requesters Relationship to Business

Check all tax types that apply and provide the account number(s).
Sales and Use Tax

Corporate Tax

Employer Withholding

Other Tax Type

SECTION II

REQUESTER CONTACT INFORMATION
User ID of Registered Individual

Individual Registered on e-TIDES
Email Address

Business Name

SECTION III

Telephone Number

SIGNATURE OF REGISTERED INDIVIDUAL AND TITLE
Title

Signature

Date

MM/DD/YYYY

PLEASE SIGN AFTER PRINTING
Completed forms can be emailed to [email protected] or faxed to 717-787-0145.

RESET FORM

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