Souderton Area School District Earned Income Tax Registration Form

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Earned Income Tax Information for
Residents of the Souderton Area School District
As you may know, school districts in Pennsylvania have tax revenue sources other than real estate taxes from which they may obtain funds to
support schools and education. Authority for levying these additional taxes was granted to local school districts and municipalities by the
Pennsylvania General Assembly in 1965 through passage of the Local Tax Enabling Act (LTEA), commonly referred to as 'Act511'. The
Earned Income Tax or 'Wage Tax' is usually a tax of one percent (1%) on gross wages and/or net profits from a business or profession.
Berkheimer Associates is the appointed earned income tax officer for the Souderton Area School District and the municipalities which
comprise the School District. As the appointed earned income tax collector, Berkheimer Associates is charged with the duty of administering
the school district's, township's, and/or borough's taxes. This includes collecting the tax, establishing rules and regulations to fairly enforce such
tax and creating accurate tax records for each taxpayer.
Below is an Earned Income Tax Registration Form. A completed Registration Form will fulfill your registration requirements under the Earned
Income Tax rules and regulations adopted by the Souderton Area School District and your resident municipality. More importantly, this
information will ensure that your tax dollars are sent to your home taxing jurisdiction. All residents should complete this form, regardless of
employment status (unemployed, retired, college student, military personnel, or homemaker). If you have recently moved, please give your
current and former address.
Most resident taxpayers will have this tax deducted by their employers. Although, if your work in a jurisdiction where it is not withheld, or you
are self-employed, you will have to pay the tax directly to Berkheimer Associates. Your completed registration form will be forwarded to
Berkheimer Associates, who will create an accurate tax account reflecting your correct reporting status and send you the necessary forms.
We appreciate your cooperation in completing the registration form. Kindly refer to the back of this letter for general questions and answers
about the earned income tax. If you have any additional questions, you may contact Berkheimer Associates at 610-588-0965, extension 2, or in
person at your local Berkheimer Office.
Souderton Area School District
Earned Income Tax Registration Form
________________________________________________________________ __________________________________________
Father’s Name (Last
First
Middle)
Father’s Social Security No.
________________________________________________________________ _________________________________________
Mother’s Name (Last
First
Middle)
Mother’s Social Security No.
Address _____________________________________________________________________________________
City __________________________________________________ State _______________ Zip ____________
Resident Municipality (Township or Borough in which you reside) - Mark one:
____Telford Borough
____ Franconia Township
____ Souderton Borough
____ Upper Salford Township
____ Salford Township
____ Lower Salford Township
Date you moved to the above address ___________________________
Did you move here from another Pennsylvania location?
Yes ____ No ____
If yes, please list previous address and resident school district ______________________________________________
Mother's Employer _____________________________________
Father's Employer __________________________________
Working Jurisdiction (Twp/Boro/City) ___________________
Working Jurisdiction (Twp/Boro/City) __________________
Is the Earned Income Tax withheld from your pay? Yes ___ No ___
From Spouse's Pay? Yes ___ No ___
Are you self-employed? Yes ___ No ___
Is your spouse self-employed? Yes ___ No ___
If you have no earned income, please record the reason why (e.g. retired/homemaker/temporarily unemployed/disabled/student/minor (please
state age)/other (please specify)) ___________________________________________________
You _______________________________________________
Spouse _______________________________________
Your Signature _______________________________________________________________
Date _____________________

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