Form 531 - Local Earned Income Tax Return - 2003
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1TAX OFFICE USE ONLY - DO NOT WRITE IN THIS AREA.
2003
RETURN BY APRIL 15, 2004 TO:
CAPITAL TAX COLLECTION BUREAU
LOCAL EARNED INCOME
See Page 3 of Instruction Sheets
TAX RETURN (FORM 531)
in this packet for mailing address labels or
Click Here to Clear Form Data
see back of Taxpayer’s Copy of return for
addresses, phone numbers, and office hours.
TO CONSTITUTE PROOF OF FILING, THE TAXPAYER’S COPY MUST
BE VALIDATED BY THE BUREAU. TO HAVE YOUR COPY VALIDATED
BY MAIL, RETURN BOTH THE TAX BUREAU’S AND TAXPAYER’S COPIES
ALONG WITH A SELF ADDRESSED STAMPED ENVELOPE.
SOC. SEC. NO.
A
SOC. SEC. NO.
B
A HUSBAND AND WIFE MAY BOTH FILE ON THIS FORM. HOWEVER, TAX CALCULATIONS MUST BE
YOUR SOC. SEC. NO.
SPOUSE’S SOC. SEC. NO.
REPORTED IN SEPARATE COLUMNS. JOINT FILING (i.e., COMBINING INCOME, ETC.) IS NOT PERMITTED.
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1
W-2 EARNINGS (From attached W-2’s)
1
2
EMPLOYEE BUSINESS EXPENSES (Attached Federal Form 2106 & State Schedule UE)
2
3
TAXABLE W-2 EARNINGS LESS EBEs (Subtract Line 2 from Line 1)
3
0.00
0.00
4
OTHER TAXABLE EARNED INCOME (NO INTEREST OR DIVIDENDS) LIST TYPE: _____________
4
5
TOTAL TAXABLE EARNED INCOME (Add Lines 3 and 4)
5
0.00
0.00
ENTER ONLY 10% OF NET LOSS(ES) FROM BUSINESS, PROFESSION, OR FARM (See instructions for more information). Report remainder of
6
DO NOT USE THIS LINE
6
Net Loss(es) on Line 9 below. Report Net Profit(s) on Line 8 below. (Attach Federal and State Schedules C, F and/or K-1 (1065))
DO NOT USE THIS LINE
7
SUBTOTAL (Subtract Line 6 from Line 5) IF LESS THAN ZERO, ENTER ZERO
7
(Attach Federal and State Schedules C, F
8
NET PROFIT(S) FROM BUSINESS, PROFESSION, OR FARM
8
and/or K-1 (1065))
(Attach Federal and State Schedules C, F
9
ENTER ONLY 90% OF NET LOSS(ES) from Business, Profession or Farm
9
NET LOSS(ES) FROM BUSINESS, PROFESSION, OR FARM
and/or K-1 (1065))
0.00
10
Subtract Line 9 from Line 8 (IF LESS THAN ZERO, ENTER ZERO)
10
0.00
REQUIRED FOR INFORMATION PURPOSES ONLY: Enter Net, Subchapter S Corporation pass-thru Net Profit(s)/Loss(es) as reported
11
11
on your PA-40 return
0.00
(Add Lines 5 and 10)
12
TOTAL TAXABLE EARNED INCOME AND NET PROFITS (Add Line 7 and 10)
12
0.00
2.00%
2.00%
13
ENTER TAX RATE FROM THE “TAX RATE TABLE” FOUND ON THE LAST PAGE OF THIS FORM PACKET
13
0.00
0.00
14
TAX LIABILITY: Multiply Line 12 by Line 13
14
15
TOTAL LOCAL INCOME TAXES WITHHELD EXCEPT PHILADELPHIA INCOME TAX (From attached W-2’s, Box 19)
15
16
QUARTERLY PAYMENTS AND/OR LAST YEAR’S OVERPAYMENT CREDITED TO THIS YEAR
16
CREDITS FOR TAXES PAID TO PHILADELPHIA AND/OR STATES OTHER THAN PA (ATTACH SCH. G) AND/OR CREDITS
17
17
FOR CERTIFIED RESIDENTS OF THE HARRISBURG KEYSTONE OPPORTUNITY ZONE (KOZ)
0.00
18
TOTAL WITHHOLDINGS & PAYMENTS (Add Line 15, 16 and 17)
18
0.00
19
TAX BALANCE DUE (Subtract Line 18 from Line 14) PAYMENT NOT NECESSARY IF LESS THAN $1.00
19
0.00
0.00
20
INTEREST & PENALTY (See Instructions)
20
21
TOTAL BALANCE DUE (Add Lines 19 and 20) Make check payable to “CTCB”
21
0.00
0.00
0.00
0.00
22
OVERPAYMENT (Subtract Line 14 from Line 18) IF LESS THAN ZERO, ENTER ZERO
22
23
OVERPAYMENT TO BE REFUNDED
23
0.00
0.00
ENTER “TAXPAYER”
CHECK ONE
ROUTING NO.
ACCOUNT NO.
“SPOUSE” OR “BOTH”
CHECKING
SAVINGS
DIRECT
SELECT
DEPOSIT
INFORMATION
SELECT
24
OVERPAYMENT TO BE CREDITED TO NEXT YEAR’S TAX
24
25
OVERPAYMENT TO BE CREDITED TO SPOUSE’S BALANCE DUE FOR THIS FILING YEAR
25
TYPE OR PRINT INFORMATION BELOW. IF PREPRINTED, 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
DAYTIME PHONE NUMBER
(TOWNSHIP, BOROUGH, OR CITY)
SELECT YOUR MUNICIPALITY
YOUR CTCB ACCOUNT
YOUR NAME
A
YOUR SOCIAL SECURITY NUMBER
NUMBER (IF KNOWN)
(LAST, FIRST, MI)
SPOUSE’S CTCB ACCOUNT
SPOUSE’S NAME
B
SPOUSE SOCIAL SECURITY NUMBER
NUMBER (IF KNOWN)
(LAST, FIRST, MI)
HAVE YOU MOVED FROM THE
YES
IF YES, COMPLETE SCHEDULE P
HOME
BEGINNING OF THE TAX FILING
ON BACK OF “BUREAU’S” COPY
ADDRESS
YEAR TO PRESENT?
NO
OF RETURN
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
YOUR OCCUPATION
X
4/21/2004
SPOUSE’S SIGNATURE (ONLY IF ALSO FILING ON THIS FORM)
DATE
SPOUSE’S OCCUPATION (ONLY IF ALSO FILING ON THIS FORM)
X
4/21/2004
PAID PREPARER’S NAME (PLEASE PRINT)
FIRM’S NAME (OR ENTER “S.E.” IF SELF EMPLOYED)
PAID PREPARER’S PHONE NUMBER
Bureau's Copy
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