Affidavit Of Information To Support The Exoneration Request For Township Occupation Tax Form

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LOWER SWATARA TOWNSHIP
Affidavit of information to support the exoneration request for Township Occupation Tax
Tax Year _____
NAME_________________________________________
ADDRESS_____________________________________________ BILL NO.________
PHONE NUMBER ______________SOCIAL SECURITY NUMBER_______________
AGE________
DATE OF BIRTH_____________
Are you currently employed or self employed? YES_____NO_____ If you answered yes, what will your
estimated earnings be from January 1, _____ to December 31, _____
Are you currently retired?
YES________NO________
I swear that the information given on the foregoing questionnaire is true and correct based upon personal
knowledge that if I engage in any pursuit for which I receive compensation, monetary or otherwise, I will report
this fact to the Township Tax Collector or to the Finance Department of Lower Swatara Township.
_______________________________
______________
Signature of person seeking exoneration
Date
Submit application to:
Berkheimer Tax Administrator
PO Box 25144
Lehigh Valley, PA 18002-5144
EXONERATION POLICY
1.
No township resident may be exonerated from the Per Capita Taxes except those who are under the age
of 18 or over the age of 72. High School students are exempt from payment.
2.
The following persons are not liable for payment of the Occupation Tax
a. A person who will receive less than $5,000 in earned income for the current tax year (January 1 to
December 31). Only earned income should be considered. Pensions, Social Security, etc. should not
be included.
b. Persons on active military duty.
c. A person who is mentally or physically incapacitated.
d. A person who is over the age of 72.
If you qualify for exoneration from the Occupation Tax, and if you are still required to pay the two $5.00 Per
Capita Taxes please do so according to the following schedule
.
PERIOD
TOWNSHIP PER CAPITA
July-August
$ 9.80
September-October
$10.00
November-December
$11.00
Payments, along with this form, must be postmarked by December 31, of the current tax year in order to avoid
additional charges and collection by Powell, Rogers and Speaks.
2015.02.20

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