Form Em-1 - Emergency And Municipal Services Tax 2007
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1EM-1 2007
EMERGENCY & MUNICIPAL
SERVICES TAX
CFD
For Employers & Self-Employed Individuals
City of Pittsburgh
Rev 09/06 FOR OFFICIAL USE ONLY
Amended Return ( )
Tax Return No Longer Needed ( )
CITY ID
FEDERAL ID
Complete Discontinuation Form
SIGNATURE _____________________________________________
TAX PERIOD
Due on or before
TITLE _____________________ DATE _______________________
PHONE _________________________________________________
E-MAIL ADDRESS ________________________________________
PREPARER’S NAME ______________________________________
PREPARER’S PHONE ______________________________________
I hereby certify, swear and aver that all statements herein are true and correct to the best of my knowledge and
belief, being duly apprised of my duty under the law to submit honest and complete information or be subject to the
penalties provided by law.
Make name/address corrections above
OMISSION OF THE ABOVE APPLICABLE INFORMATION
USE BLACK INK ONLY ON THIS FORM
CONSTITUES AN INCOMPLETE RETURN
EMERGENCY & MUNICIPAL SERVICES TAX IS $52.00 PER EMPLOYEE, PER YEAR
1. NUMBER OF EM-2s REPORTED
This includes employees, sole proprietor and partners.
2. GROSS AMOUNT OF TAX - LINE 1 MULTIPLIED BY $52.00
You must include explanation, below, if payment is not a multiple of $52.00
3. PENALTY AND INTEREST IS 6% PER MONTH, IF APPLICABLE
Penalty per Month 5% (0.05) (Maximum 50%), Interest per Month 1% (0.01)
4.
TOTAL PAYMENT THIS MONTH - ADD LINES 2 & 3
.
If no payment is due DO NOT send in this form.
Make check payable to: TREASURER, CITY OF PITTSBURGH – DO NOT SEND CASH
Mail to: CITY TREASURER EM-1 TAX – PO BOX 642606 – PITTSBURGH PA 15264-2606
You must include explanation, below, if payment is not a multiple of $52.00
A $30.00 fee will be assessed for any check returned from the bank for any reason.
EMERGENCY & MUNICIPAL SERVICES TAX (EM-1)
SECTION B – EXPLANATION – If payment is not in multiples of $52.00, you MUST include an
explanation to avoid penalty and interest charges.
If necessary attach additional sheets
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