Form Et 1 - Local Taxpayers Bill Of Rights
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1FORM ET 1
1. TOTAL EARNED INCOME TAX WITHHELD
1
2. TOTAL OCC. PRIV TAX WITHHELD = $10.00/EMPLOYEE
2
EMPLOYER’S EARNED INCOME TAX
3. OCC. PRIV. TAX DISCOUNT - LINE 2 X 2% (.02)
AND OCCUPATIONAL PRIVILEGE TAX
3
4. NET OCC. PRIV. TAX DUE - LINE 2 LESS LINE 3
RETURN FOR PERIOD SHOW BELOW
4
5. TOTAL TAX DUE - ADD LINES 1 AND 4
IF AN OFFICIAL RECEIPT IS DESIRED RETURN BOTH
5
6. INTEREST AND PENALTY 1% PER MONTH
COPIES WITH YOUR REMITTANCE AND A SELF
ADDRESSED ENVELOPE.
(1/2% INTEREST AND 1/2% PENALTY)
6
7. TOTAL PAYMENT DUE - ADD LINES 5 & 6
I DECLARE UNDER PENALTY OF LAW THAT THIS IS A
7
TRUE AND CORRECT RETURN.
DATE BUSINESS CLOSED OR DISCONTINUED
AUTHORIZED SIGNATURE
TITLE
Include payment with
this return payable to:
CITY OF ALLENTOWN
435 Hamilton St., Room 110
Allentown, PA 18101-1686
610-437-7507
CITY COPY
1. TOTAL EARNED INCOME TAX WITHHELD
FORM ET 1
1
2. TOTAL OCC. PRIV TAX WITHHELD = $10.00/EMPLOYEE
2
EMPLOYER’S EARNED INCOME TAX
3. OCC. PRIV. TAX DISCOUNT - LINE 2 X 2% (.02)
AND OCCUPATIONAL PRIVILEGE TAX
3
4. NET OCC. PRIV. TAX DUE - LINE 2 LESS LINE 3
RETURN FOR PERIOD SHOW BELOW
4
5. TOTAL TAX DUE - ADD LINES 1 AND 4
IF AN OFFICIAL RECEIPT IS DESIRED RETURN BOTH
5
6. INTEREST AND PENALTY 1% PER MONTH
COPIES WITH YOUR REMITTANCE AND A SELF
ADDRESSED ENVELOPE.
(1/2% INTEREST AND 1/2% PENALTY)
6
7. TOTAL PAYMENT DUE - ADD LINES 5 & 6
I DECLARE UNDER PENALTY OF LAW THAT THIS IS A
7
TRUE AND CORRECT RETURN.
DATE BUSINESS CLOSED OR DISCONTINUED
AUTHORIZED SIGNATURE
TITLE
Include payment with
this return payable to:
CITY OF ALLENTOWN
435 Hamilton St., Room 110
Allentown, PA 18101-1686
610-437-7507
EMPLOYER COPY
LOCAL TAXPAYERS BILL OF RIGHTS
You are entitled to receive a written explanation of your rights with regard to the audit, appeal,
enforcement, refund and collection of local taxes by calling City of Allentown at (610) 437-7501
during the hours of 7:30 a.m. - 4:30 p.m.
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