Form Er-1 - Employer Annual Earned Income Tax Reconciliation

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EMPLOYER ANNUAL EARNED INCOME TAX RECONCILIATION
ER-1
FORM
DISTRICT/MUNICIPALITY: __________________________________________________________________
Due by February 28
Tax Year ________
Employer Name and Address:
Federal ID Number:
1. Number of W-2 statements attached to this report
_____________
2. Total tax withheld as shown on attached W-2 statements
$_____________
3. Quarterly tax withheld and previously reported (EQ-1)
st
1
Quarter ending March 31
$______________
nd
2
Quarter ending June 30
$______________
rd
3
Quarter ending September 30
$______________
th
4
Quarter ending December 31
$______________
TOTAL REMITTED
$_____________
4. Any difference between lines 2 and 3 must be fully explained in attached statement.
I certify that the information on this Form ER-1 is correct and complete.
Signature_______________________________________________ Date___________________________
FORM ER-1 INSTRUCTIONS
►
To electronically file your annual reconciliation, go to
►
Include employer full name and address.
►
List Federal Employer ID number.
Line 1
File reconciliation on or before February 28. Include a copy of the W-2 Form for each employee.
Line 2
Enter total tax withheld as shown on W-2 Forms.
Line 3
Enter the withheld earned income tax as previously reported for each quarter.
►
Remit additional amount owed when filing this reconciliation.
►
Employers using multiple Federal Tax (EIN) identifiers must file separate Form ER-1 reconciliations and
include the applicable W-2 forms.
►
Remit filing to Keystone Collections Group, 546 Wendel Road, Irwin, PA 15642.

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