Fill in PDF form from PHP and generate new PHP

This project is for a simple web form that will populate two areas of a PDF form. The PDF form is located here - [login to view URL] The fields that need to be populated are the text box "Taxpayer name(s) and address" and "Social Security Number". The HTML form should have a free form text for the address and a three text boxes for the Social Security Number. This website may be useful - [login to view URL] Use of pdftk is okay as well ([login to view URL]). Deliverables shall be one HTML file that first displays the form, then when passed form variables, files in the PDF and sends the PDF to the form requester. Clean, well-commented, object orientated code is essential.