Form Clgs-32-1 - Taxpayer Annual Local Earned Income Tax Return - 2016
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2CLGS-32-1 (04-16)
TAXPAYER ANNUAL
LOCAL EARNED INCOME TAX RETURN
You are entitled to receive a written explanation of your rights with regard to the audit, appeal, enforcement, refund and collection of local taxes. Contact your Tax Officer.
Tax Year
*If you have relocated during the tax year, please supply additional information.
DATES LIVING AT EACH ADDRESS
STREET ADDRESS (No PO Box, RD or RR)
CITY OR POST OFFICE
STATE
ZIP
/
/
/
/
TO
/
/
/
/
TO
**If you need additional space - please see back of form.
LAST NAME, FIRST NAME, MIDDLE INITIAL
SPOUSE’S LAST NAME, FIRST NAME, MIDDLE INITIAL
STREET ADDRESS (No PO Box, RD or RR)
SECOND LINE OF ADDRESS
CITY
STATE
ZIP CODE
DAYTIME PHONE NUMBER
RESIDENT PSD CODE
EXTENSION
AMENDED RETURN
NON-RESIDENT
Social Security #
Spouse’s Social Security #
The calculations reported in the first column MUST pertain to the name printed
in the column, regardless of whether the husband or wife appears first.
Combining income is NOT permitted.
If you had NO EARNED INCOME,
If you had NO EARNED INCOME,
check the reason why:
check the reason why:
ONLY USE BLACK OR BLUE INK TO COMPLETE THIS FORM
disabled
student
disabled
student
deceased
military
deceased
military
homemaker
retired
homemaker
retired
unemployed
unemployed
1. Gross Compensation as Reported on W-2(s). (
) . . . . . . . . . . . . .
.00
.00
Enclose W-2s
2. Unreimbursed Employee Business Expenses. (
) . . . .
.00
.00
Enclose PA Schedule UE
3. Other Taxable Earned Income * . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.00
.00
4. Total Taxable Earned Income
. . . .
.00
.00
(Subtract Line 2 from Line 1 and add Line 3)
5. Net Profit (
*)
Enclose PA Schedules
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.00
.00
NON-TAXABLE S-Corp earnings check this box:
6. Net Loss (
*) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.00
.00
Enclose PA Schedules
7. Total Taxable Net Profit
. .
.00
.00
(Subtract Line 6 from Line 5. If less than zero, enter zero)
8. Total Taxable Earned Income and Net Profit (
) . . . . . . . . . . . .
.00
.00
Add Lines 4 and 7
9. Total Tax Liability (
) . . . . . . . . . . . . . . . .
.00
.00
Line 8 multiplied by
10. Total Local Earned Income Tax Withheld
.00
.00
(May not equal W-2 - See Instructions)
11.Quarterly Estimated Payments/Credit From Previous Tax Year . . . . . . . . . . .
.00
.00
12. Out-of-State or Philadelphia Credits
. . . . . .
.00
.00
(include supporting documentation)
13. TOTAL PAYMENTS and CREDITS (
) . . . . . . . . . . . .
.00
.00
Add Lines 10 through 12
14. Refund IF MORE THAN $1.00, enter amount
.00
.00
(or select option in 15) . . . . . . . .
15. Credit Taxpayer/Spouse (
) . . .
Amount of Line 13 you want as a credit to your account
.00
.00
Credit to next year
Credit to spouse
16. EARNED INCOME TAX BALANCE DUE (
) . . . . . . . . . . .
.00
.00
Line 9 minus Line 13
17. Penalty after April 15* (
) . . . . . . . . . . . . . . . .
.00
.00
multiply Line 16 by
18. Interest after April 15* (
) . . . . . . . . . . . . . . . . .
.00
.00
multiply Line 16 by
19. TOTAL PAYMENT DUE (
) . . . . . . . . . . . . . . . . . . . . .
.00
.00
Add Lines 16, 17, and 18
*See Instructions
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.
YOUR SIGNATURE
SPOUSE’S SIGNATURE (If Filing Jointly)
DATE (MM/DD/YYYY)
PREPARER’S PRINTED NAME & SIGNATURE
PHONE NUMBER
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