Berkheimer Estimated Earned Income Tax Form

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TAX YEAR
QUARTER
1. Estimated Earned Income
SOCIAL SECURITY NUMBER
If you have no earned income, choose the appropriate reason.
Blank
RESIDENT MUNICIPALITY
If minor, state age
If other, specify
2. Tax Rate
X
0.00
NAME
Click here to find out what your tax rate is.
ADDRESS
3. Employer Withheld
0.00
4. Tax Due
PA
CITY
STATE
ZIP CODE
5. Penalty & Interest
E-MAIL
0.00
6. Total Payment Due
PHONE NUMBER
Instructions
Save Copy
Print
E-Mail A $0 Due Form

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