Form 531 - Local Earned Income Tax - 2012
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1TAX OFFICE USE ONLY - DO NOT WRITE IN THIS AREA
2012
RETURN BY APRIL 15, 2013
TO:
LOCAL EARNED INCOME TAX
CAPITAL TAX COLLECTION BUREAU
RETURN (FORM 531)
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
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 REPORTED IN SEPARATE
COLUMNS. JOINT FILING (I.E., COMBINING INCOME, ETC.) IS NOT PERMITTED.
W-2 EARNINGS (From attached W-2s)
1
1
2
EMPLOYEE BUSINESS EXPENSES (EBEs) (Attached Federal Form 2106 & State Schedule UE)
2
3
TAXABLE W-2 EARNINGS LESS EBEs (Subtract Line 2 from Line 1)
3
OTHER TAXABLE EARNED INCOME (NO INTEREST OR DIVIDENDS) LIST TYPE:__________________
4
4
5
TOTAL TAXABLE EARNED INCOME (Add Lines 3 and 4)
5
6
NET PROFIT FROM BUSINESS, PROFESSION OR FARM (Attach Federal and State Schedules C, F and/or K-1 (1065))
6
7
7
NET LOSS(ES) FROM BUSINESS, PROFESSION OR FARM (Attach Federal and State Schedules C, F and/or K-1 (1065))
8
Subtract Line 7 from Line 6 (IF LESS THAN ZERO, ENTER ZERO)
8
REQUIRED FOR INFORMATION PURPOSES ONLY: Enter Net, Subchapter S Corporation pass-thru Net Profit(s)/Loss(es) as reported on
9
9
your PA-40 return
TOTAL TAXABLE EARNED INCOME AND NET PROFITS (Add Lines 5 and 8)
10
10
11
TAX RATE (If you moved, you need to complete Schedule P)
11
12
TAX LIABILITY: Multiply Line 10 by Line 11
12
TOTAL LOCAL INCOME TAXES WITHHELD EXCEPT PHILADELPHIA INCOME TAX (From attached W-2s, Box 19)
13
13
QUARTERLY PAYMENTS AND/OR LAST YEAR’S OVERPAYMENT CREDITED TO THIS YEAR
14
14
CREDITS FOR TAXES PAID TO PHILADELPHIA AND/OR STATES OTHER THAN PA (ATTACH SCH. G) AND/OR CREDITS FOR
15
15
CERTIFIED RESIDENTS OF THE HARRISBURG KEYSTONE OPPORTUNITY ZONE (KOZ)
TOTAL WITHHOLDINGS & PAYMENTS (Add Lines 13, 14 and 15)
16
16
17
TAX BALANCE DUE (Subtract Line 16 from Line 12) PAYMENT NOT NECESSARY IF LESS THAN $1.00
17
18
INTEREST & PENALTY (See Instructions)
18
RETURNS FILED AFTER THE DUE DATE MAY BE SUBJECT TO ADDITIONAL COSTS OF COLLECTION
19
19
20
TOTAL BALANCE DUE (Add Lines 17, 18 and 19) Make check payable to "CTCB"
Place Social security Number on Check
20
21
OVERPAYMENT (Subtract Line 12 from Line 16) IF LESS THAN ZERO, ENTER ZERO
21
OVERPAYMENT TO BE REFUNDED
22
22
ROUTING NO.
ACCOUNT NO.
Taxpayer 'A', 'B', or 'BOTH' Savings or Checking Acct.
DIRECT
DEPOSIT
INFORMATION
23
OVERPAYMENT TO BE CREDITED TO NEXT YEAR'S TAX
23
24
OVERPAYMENT TO BE CREDITED TO SPOUSE'S BALANCE DUE FOR THIS FILING YEAR
24
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 PIN NUMBER FOR
YOUR NAME
A
YOUR CTCB ACCOUNT NUMBER (IF KNOWN)
ONLINE FILING
(LAST, FIRST, M)
Enter at right >>>>>>>>>
SPOUSE'S PIN NUMBER
SPOUSE'S NAME
B
SPOUSE'S CTCB ACCOUNT NUMBER (IF KNOWN)
FOR ONLINE FILING
(LAST, FIRST, M)
Enter at right >>>>>>>>>
YES
HAVE YOU MOVED FROM THE
IF YES, COMPLETE SCHEDULE P
HOME
BEGINNING OF THE TAX FILING
ON BACK OF "BUREAU'S COPY"
ADDRESS Enter at right >>
NO
YEAR TO PRESENT?
OF RETURN.
DAYTIME PHONE NUMBER
YOUR RESIDENT MUNICIPALITY
(TOWNSHIP, BOROUGH OR CITY)
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
X
X
X
SPOUSE'S SIGNATURE (ONLY IF ALSO FILING ON THIS FORM)
DATE
SPOUSE'S OCCUPATION (ONLY IF ALSO FILING ON THIS FORM)
X
X
X
X
PAID PREPARER’S NAME (PLEASE PRINT)
FIRM’S NAME (OR ENTER “S.E.” IF SELF EMPLOYED)
PAID PREPARER’S PHONE NUMBER
TAXPAYER'S COPY
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