Local Earned Income Tax Return Form - 2005
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1RETURN DUE DATE, APRIL 15
MIFFLIN COUNTY SCHOOL DISTRICT
Please staple W-2 forms to
LOCAL EARNED INCOME TAX RETURN
TAX YEAR 2005
the BACK, and checks to
MIFFCO TAX SERVICE, INC., 139 WEST MARKET STREET, P.O.BOX 746, LEWISTOWN, PA 17044
the FRONT in this corner.
TEL: (717) 242-2777 FAX: (717) 242-6132
IF YOU MOVED DURING THIS TAX YEAR, PLEASE PROVIDE.
PREVIOUS
ADDRESS
CURRENT
ADDRESS
DATE MOVED
MO.
DAY
YR.
SOC. SEC. NO. A
SOC. SEC. NO. B
A HUSBAND AND WIFE MAY BOTH FILE ON THIS FORM, HOWEVER, TAX CALCULATIONS MUST BE
REPORTED IN SEPARATE COLUMNS. JOINT FILING (COMBINE INCOME, ETC.) IS NOT PERMITTED.
1
W-2 EARNINGS
(From attached W-2’s - Use Local Box 18 or State Box 16 Wages only)
1
LIMITATIONS APPLY
2
EMPLOYEE BUSINESS EXPENSES
(Attach State Schedule UE and Federal 2106 if used )
2
SEE INSTRUCTIONS
3
TAXABLE W-2 EARNINGS
( Subtract line 2 from Line 1)
3
ATTACH
4
OTHER TAXABLE EARNED INCOME (NO INTEREST OR DIVIDENDS)
4
SUPPORT
XXXXXXXXXXXX XXXXXXXXXXXX
4a (INFO ONLY) K-1 EARNINGS $____________SUB_S CORP. $_______________PASSIVE PARTNERSHIP
4a
5
TOTAL TAXABLE EARNED INCOME
(Add Lines 3 and 4)
5
ATTACH
6
NET LOSS FROM BUSINESS, PROFESSION, OR FARM
(Use Line 8 for any Net Profits)
6
SCHEDULES
7
ADJUSTED EARNED INCOME
IF LESS THAN ZERO ENTER ZERO
7
(Subtract Line 6 from Line 5)
ATTACH
8
NET PROFIT FROM BUSINESS, PROFESSION, GUARANTEED PMTS, OR FARM
(Use Line 6 for any Net Losses.)
8
SCHEDULES
9
TOTAL TAXABLE EARNED INCOME AND NET PROFITS
(Add Lines 7 and 8)
9
10 TAX LIABILITY: 1.35% of Line 9
DO NOT ROUND NUMBERS.
10
(Multiply Line 9 by .0135)
11 TOTAL LOCAL INCOME TAXES WITHHELD
DO NOT ROUND NUMBERS.
(From attached W-2’s, Box 19)
OUT OF STATE CREDIT, PHILADELPHIA TAX CREDIT up to Local Tax Liability
11
DO NOT
12 QUARTERLY PAYMENTS AND/OR LAST YEAR’S OVERPAYMENT CREDITED TO THIS YEAR
12
ROUND
NUMBERS
13 TOTAL WITHHOLDINGS & PAYMENTS
DO NOT ROUND NUMBERS.
13
(Add Lines 11 and 12)
DO NOT
14 OVERPAYMENT-REFUND DUE
ROUND
(Subtract Line 10 from Line 13)
14
NUMBERS
15 AMOUNT OF REFUND TO BE CREDITED TO NEXT YEAR
15
16 AMOUNT OF REFUND TO BE TRANSFERRED TO SPOUSE’S CURRENT TAX BALANCE DUE
16
17 TAX BALANCE DUE
(Subtract Line 13 and Line 16 from Line 10).
17
18 INTEREST AND PENALTY -1% PER MONTH OF LINE 10 LESS LINE 13 AFTER APRIL 15, LATE FILING FEE
18
19 TOTAL BALANCE DUE (Add line 17 and 18) Make Checks Payable to MIFFCO.
19
TYPE OR PRINT INFORMATION BELOW. IF PRE-PRINTED, CHECK FOR ACCURACY AND MAKE CORRECTIONS WHERE NECESSARY.
SPOUSE’S NAME, SIGNATURE, AND OTHER INFORMATION SHOULD BE PROVIDED ONLY IF HE OR SHE IS ALSO FILING ON THIS FORM.
YOUR RESIDENT MUNICIPALITY
(TOWNSHIP OR BOROUGH)
TAX OFFICE USE ONLY
YOUR TELEPHONE#
TAX PREPARERS TELEPHONE#
CHECK IF FINAL RETURN
CHECK TO OFFSET BALANCE DUE WITH SPOUSE OVERPAYMENT
CHECK IF USING PAID PREPARER AND WILL NOT NEED FORMS NEXT YEAR
FOR PERMISSION TO ALLOW ANOTHER PERSON TO DISCUSS THIS RETURN WITH TAX COLLECTOR
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE EXAMINED THIS RETURN AND ACCOMPANYING SCHEDULES AND
STATEMENTS, AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, THEY ARE TRUE, CORRECT, AND COMPLETE.
YOUR SIGNATURE
DATE
CURRENT EMPLOYER
SPOUSE’S SIGNATURE (ONLY IF ALSO FILING ON THIS FORM)
DATE
CURRENT EMPLOYER
PREPARER’S NAME (PLEASE PRINT)
FIRM’S NAME (OR ENTER “S.E.” IF SELF EMPLOYED
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