Form 531 - Earned Income Tax Return - 2004
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1
2WEST SHORE TAX BUREAU
EARNED INCOME TAX RETURN
2004
PHONE: (717) 761-4900
FORM 531
WEB SITE:
$
SECTION
COMPLETE THIS SECTION ONLY IF YOU MOVED DURING 2004 AND ACCOUNT FOR ALL 12 MONTHS
A
# OF
PSD
B
TIME PERIOD
MONTHS
CODE
RESIDENT ADDRESS
CITY/BOROUGH/TOWNSHIP
/
/
/
/
04
04
TO
/
/
/
/
04
TO
04
IF YOU MOVED DURING 2004: List below the number of months in 2004 you may have been a resident of each municipality and school district.
And refer to the (Schedule X) on the reverse side of this return to calculate your tax liability.
A
/
/
/
/
TO
04
04
B
/
/
/
/
04
TO
04
CITY/BOROUGH/TOWNSHIP
PSD
SCHOOL DISTRICT OF RESIDENCE
WHERE YOU PRESENTLY RESIDE
CODE
If the figures on your return are from Schedule X, check here:
TAXPAYER A
TAXPAYER B
TAXPAYER
A
SOCIAL
SECURITY NO.
TAXPAYER
B
SOCIAL
SECURITY NO.
A
B
TAXPAYER
TAXPAYER
#
SECTION
1
W-2 Earnings. (from section " reverse
1.
side)
Enclose W-2 Forms for each employer.
2
(
)
2.
Less employee business expenses.
Enclose PA Schedule UE
3
(
)
Do not include interest, dividends or capital gains.
3.
Other taxable earned income.
Complete Section ! on back.
4
)
(
ENCLOSE ALL PA SCHEDULES C, F, G, I,
4.
Net loss from Business, Farm, or Profession
J, RK-1, NRK-1
5
5.
Total taxable earned income. (Not less than
zero.)
)
(
ENCLOSE ALL PA SCHEDULES C, F, G, I,
6.
Net profit from Business, Farm, or Profession
6
J, RK-1, NRK-1
7
7.
Total taxable earned income and net profit. (Add lines 5 &
6)
DO NOT ROUND FIGURES BELOW LINE 7.
8
Total tax liability
USE APPLICABLE TAX RATE FROM TAX TABLE ON
8.
REVERSE SIDE OF FORM OR TOTAL OF LINE 8 FROM SCHEDULE
X.
9
Total local income tax withheld as per enclosed W-2's
9.
DO NOT INCLUDE PHILADELPHIA TAX
10
2004 quarterly tax payments,
plus out of state tax credit,
plus 2003 tax
10.
overpayment transferred into 2004 tax year, plus Philadelphia tax paid.
11
11.
Add lines 9 and 10
12
12.
Refund due. (Line 11 minus line
8)
IF LESS THAN $1.00 ENTER ZERO
13
13.
Amount of refund to be transferred into 2005
14
14.
Amount of refund to be transferred to spouse's 2004 tax due
15
Tax balance due. (Line 8 minus line
11)
15.
IF LESS THAN $1.00 ENTER ZERO
16
Penalty after April 15, see instructions
16.
17
Interest after April 15, see instructions
17.
18
Total balance due. Add lines 15, 16 and 17
18.
INCLUDE CHECK PAYABLE TO W.S.T.B.
I DECLARE UNDER PENALTIES PROVIDED BY LAW, THAT THIS RETURN IS TRUE, COMPLETE AND CORRECT.
SIGNATURE-TAXPAYER
REQUIRED
DATE
OCCUPATION
EMAIL ADDRESS
DAYTIME TELEPHONE NO.
A
SIGNATURE-TAXPAYER
REQUIRED
DATE
OCCUPATION
EMAIL ADDRESS
DAYTIME TELEPHONE NO.
B
PAID PREPARER'S NAME, PLEASE PRINT
PAID PREPARER'S TELEPHONE NUMBER
Local Earned Income and Net Profits Tax
Complete and Return by April 15, 2005.
BUREAU'S COPY
A HUSBAND AND WIFE MAY BOTH FILE ON THIS FORM, HOWEVER, TAX
CALCULATIONS MUST BE REPORTED IN SEPARATE COLUMNS, JOINT
GENERIC TAX RETURN FORMS ARE NOT ACCEPTABLE WITHOUT PRIOR WRITTEN
FILING (i.e. COMBINING INCOME, ETC.) IS NOT PERMITTED.
AUTHORIZATION FROM THIS BUREAU'S EXECUTIVE DIRECTOR.
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