Local Earned Income Tax Return Pa Eit 2015
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1
2
3LOCAL EARNED INCOME TAX RETURN
TAX YEAR
EIT
BERKS E.I.T. BUREAU | 1125 BERKSHIRE BLVD - SUITE 115, WYOMISSING, PA 19610
20 15
Form
Phone: (610) 372-8439 | Toll Free: (855) 372-8439 | Fax: (610) 372-1102
Fill in oval IF YOU MOVED during the tax year printed above. Provide each address and dates living there. NOTE: If you need additional space, please see back of form
DATES LIVING AT EACH ADDRESS
STREET ADDRESS (No PO Box, RD or RR)
CITY
STATE / ZIP CODE
TAXPAYER / SPOUSE / BOTH
/
/
TO
/
/
/
/
TO
/
/
TAXPAYER A - LAST NAME, FIRST NAME, MIDDLE INITIAL
SPOUSE B - LAST NAME, FIRST NAME, MIDDLE INITIAL
Office Use Only
STREET ADDRESS (No PO Box, RD or RR)
CITY
STATE
ZIP CODE
DAYTIME PHONE NUMBER
RESIDENT PSD CODE
EXTENSION
AMENDED RETURN
NON-RESIDENT
TAXPAYER A
SPOUSE B
This return must be filed by April 15, or next business day. Every individual is
Social Security Number
Social Security Number
required to file, whether tax is due, refund/credit due, tax is withheld, or you have
NO EARNED INCOME. Failure to file will result in audit and/or delinquent fines.
-
-
-
-
Combining income is NOT permitted.
If you had NO EARNED INCOME,
If you had NO EARNED INCOME,
fill in the reason why:
fill in the reason why:
ONLY USE BLACK OR BLUE INK TO COMPLETE THIS FORM
disabled
student
disabled
student
Single
Married, Filing Jointly
Married, Filing Separately
Final Return
deceased
unemployed
deceased
unemployed
homemaker
homemaker
retired
retired
active duty military
active duty military
Refer to instructions on Taxpayer Worksheet
1. Gross Compensation as Reported on W-2(s)
(Enclose W-2s) . . . .
1
1
2. Unreimbursed Employee Business Expenses
(Enclose PA UE and Page 1 of Form PA-40) . . . . . . . . . . . . . . . . . .
2
2
3. Other Taxable Earned Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
3
4. Total Taxable Earned Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
4
5. Net Profit from a business, farm, profession, partnership, etc.
(Enclose PA Schedules) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
5
6. Net Loss from a business, farm, profession, partnership, etc.
6
6
(Enclose PA Schedules) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7. Total Taxable Net Profit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
7
8. Total Taxable Earned Income and Net Profit . . . . . . . . . . . . . . . . . . .
8
8
9. Total Resident Local Income Tax
Fill-in appropriate rate:
1%
1.15%
3.6% . . . . .
9
9
. 9a. City of Reading Distressed Commuter Tax
(If applicable) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9a
9a
9b. Total Tax Liability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9b
9b
10. Total Local Earned Income Tax Withheld as Reported on W-2(s)
. . . . . . . .
(DO NOT INCLUDE PHILADELPHIA OR OUT OF STATE TAX) . . .
10
10
11. Quarterly Estimated Payments/Credit from Previous Tax Year
Estimated Payments
Prior Year Credit . . . . .
11
11
12. Miscellaneous Tax Credits
12
12
Philadelphia Credit
Out of State Credit . . . . . . . .
13. TOTAL PAYMENTS and CREDITS . . . . . . . . . . . . . . . . . . . . . . . . . .
13
13
14.
. .
14
14
15. Credit to Taxpayer/Spouse
(Amount of Line 14 you want as credit)
15
15
Credit to Next Year
Credit to Spouse . . . . . . . . .
16. EARNED INCOME TAX BALANCE DUE
. . . . . . . . . . . . . . . . . . . . . . .
16
16
17. Penalty & Interest after April 15, 2016 . . . . . . . . . . . . . . . . . . . . . .
17
17
18. TOTAL PAYMENT DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18
18
Under penalties of perjury, I (we) declare that I (we) have examined this information, including all accompanying schedules and statements and to the best of my
(our) belief, they are true, correct and complete.
TAXPAYER A SIGNATURE
SPOUSE B SIGNATURE (If Filing Jointly)
DATE
TELEPHONE NUMBER
TAXPAYER E-MAIL ADDRESS
PREPARER’S NAME
PREPARER’S COMPANY
PREPARER’S PHONE NUMBER
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