REV-1601: Tax Credit Certification Request Form (REV-1601) (Revision 2006-01)
Pennsylvania · Pennsylvania DOR · Used for tax years 2024, 2025, 2026
Form REV-1601 requests tax credit certification under Pennsylvania’s Employment Incentive Payment (EIP) Program. It collects employee assistance or rehabilitation services certifications, employer information, and details about the employee’s job, start date, and starting hourly
Who files this form
Employers or their authorized representatives use this form to request certification under Pennsylvania’s Employment Incentive Payment (EIP) tax credit program.
The employee must certify that they received Pennsylvania cash assistance in the GA or TANF category within the past 12 months, and/or that they are receiving or have received rehabilitation services through a state rehabilitation services program or the Veterans’ Administration.
Both the employee and the employer or authorized representative must sign the form.
When it's due
The completed form must be mailed on or before the 21st day following the employee’s start date. Forms that miss this deadline will be rejected.
The form does not print a tax-year-specific calendar deadline.
What you'll need
Have the following information ready to complete the form:
- Employee’s Social Security number, name, address, sex, signature, and signature date.
- Employer’s name, address, federal employer identification number (FEIN), and phone number.
- Employee’s start date, job title, and starting hourly wage.
- Whether the EIP tax credit contributed to the hiring decision.
- Employer or representative’s signature, printed name, and title.
- Authorized representative’s firm name and contact information, when applicable.
When filing for the EIP tax credit, the employer must submit a legible copy of the certification form with a completed PA Schedule W. The employer is responsible for maintaining the certification form.
How to file
Complete all required information clearly and legibly. Except for signatures, entries must be hand-printed or typed. Obtain both required signatures, then mail the form to:
Tax Credit Coordination Services
Labor & Industry Building, 13th Floor
7th and Forster Streets
Harrisburg, PA 17120
The form requires mailing and does not provide an e-file option.
Common mistakes
- Mailing too late: Forms must be mailed on or before the 21st day following the employee’s start date.
- Leaving items blank or omitting signatures: All items must be completed, and both signatures must be present. An incomplete form is grounds for rejection.
- Using unclear entries: Entries must be clear and legible, and must be hand-printed or typed except for signatures.
- Altering, defacing, or omitting part of the original form: Rejections for these reasons cannot be appealed.
- Missing required tax credit claim documents: When filing for the credit, submit a legible copy of the certification form with a completed PA Schedule W.
Questions people ask
Who issues the certification letter?
The Pennsylvania Department of Labor and Industry issues certification letters to the employer.
Will I be told why a request was rejected?
Yes. The Pennsylvania Department of Labor and Industry sends the employer a rejection letter stating the reason.
Can a rejection be appealed?
Only if the rejection was not for missing the mailing deadline, missing identification information or signatures, or altering, defacing, or omitting any part of the original form.
What does the employee authorize by signing?
The employee authorizes the Pennsylvania Department of Public Welfare and/or the state Office of Vocational Rehabilitation to release information to the Tax Credit Unit to determine whether the employer is eligible for a state tax credit for hiring and retaining the employee.
What phone number is listed for questions?
The form lists 800-345-2555.