For Employers and Self-Employed Individuals
City of Pittsburgh
FOR OFFICIAL USE ONLY
Amended Return ( )
Tax Return No Longer Needed ( )
See section B, Below
Due on or before
I hereby certify, swear and aver that all statements herein are true and correct to the best of my
knowledge and belief, being duly apprised of my duty under the law to submit honest and
complete information or be subject to the penalties provided by law.
Make name/address corrections above
MAKE SURE YOUR SIGNATURE AND DATE APPEAR ABOVE
USE BLACK INK ONLY ON THIS FORM
OCCUPATION TAX IS $10.00 PER EMPLOYEE, PER YEAR
1. NUMBER OF OT-2s REPORTED
This includes employees, sole proprietor and partners.
2. GROSS AMOUNT OF TAX - LINE 1 MULTIPLIED BY $10.00
You must include explanation if payment is not a multiple of $10.00.
3. PENALTY AND INTEREST IS 6% PER MONTH, IF APPLICABLE
Penalty per Month 5% (0.05)-(Maximum 50%), Interest per Month 1% (0.01)
TOTAL PAYMENT THIS QUARTER - ADD LINES 2 & 3
Make check payable to: TREASURER, CITY OF PITTSBURGH – DO NOT SEND CASH
Mail to: CITY OF PITTSBURGH OCCUPATION TAX – PO BOX 642606 – PITTSBURGH PA 15264-2606
A $30.00 fee will be assessed for any check returned from the bank for any reason.
SECTION B – STATUS CHANGE
If a business is no longer located in the City of Pittsburgh limits, but performs any type of service, contractual or otherwise within
the City limits, that business may still be liable for City/School District taxes. Contact the City of Pittsburgh Taxpayer Services
Center for further information at 412-255-8821.
If business entity discontinued all operations, give date of discontinuation:___________________________________________
Give addresses of any locations that are still open:______________________________________________________________
If the business entity has been sold, give name of the new owner:__________________________________________________
If the business entity has moved from Pittsburgh, give the date of move and address of new location:
Do you employ Pittsburgh residents? ( ) Yes or No ( )
Do you own the building where the business or rental was located? ( ) Yes or No ( )