Form Pa-40ez - 2000 - Wage Tax Statement
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2PA-40EZ - 2000
0000310029
PA-40EZ (09–00)
PA DEPARTMENT OF REVENUE,
OFFICIAL USE ONLY
Harrisburg, PA 17129-0003
Pennsylvania Income Tax Return Commonwealth of Pennsylvania
PLEASE PRINT IN BLACK INK. ENTER ONE LETTER OR NUMBER IN EACH BOX. FILL IN OVALS COMPLETELY.
START
Your Social Security Number
Spouse’s Social Security Number
HERE
Identification Label Change.
Fill in this oval if the label you received with
this booklet is not completely correct, or
Last Name
if you did not file a 1999 PA tax return.
Do not make corrections on the label --
DISCARD IT.
RESET BOTH BUTTONS
Your First Name
MI
Overseas Mail
Important. If you moved into or out of
Pennsylvania during 2000, you must file a
Use full return
PA-40.
Spouse’s First Name
MI
address to include city,
Amended Return. Fill in this oval if you
country, and Zip Codes
are amending your 2000 PA return.
in local formats.
Spouse’s Last Name - Only if different from Last Name above
Type Filer. Fill in only one oval.
Single
S
First line of address - P.O. Box; Apartment Number; Suite; RR No. - if applicable
Married, Filing Jointly
J
Second line of address - Street Address
Married, Filing Separately
M
Important. If a final return or filing for a
deceased person, you must use a PA-40.
See Forms Ordering.
City or Post Office
State
ZIP Code
RESET ALL OF THE ABOVE BUTTONS
County where you lived on 12/31/00.
School Code
Daytime Telephone Number
Municipality where you lived on 12/31/00.
Name of school district where you lived on 12/31/00.
Do not use cents. Enter whole dollars.
ENTER ONLY WHOLE DOLLAR AMOUNTS ONLY BELOW.
1a. Gross Compensation from PA Schedule W-2S, or your Form(s) W-2, or other statements. . . . . . . .
1a.
1b. Unreimbursed Employee Business Expenses, from PA Schedule UE . . . . . . . . . . . . . . . . . . . . . . .
1b.
1c. Net Compensation. Subtract Line 1b from Line 1a. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c.
2. Interest Income. Complete and enclose a PA Schedule A, if over $2,500. . . . . . . . . . . . . . . . . . . . .
2.
3. Dividend Income. Complete and enclose a PA Schedule B, if over $2,500. . . . . . . . . . . . . . . . . . . .
3.
4. Total PA Taxable Income. Add Lines 1c, 2, and 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.
5. PA Tax Liability. Multiply Line 4 by 2.8% (0.028). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.
6. Total PA Tax Withheld, from PA Schedule W-2S, or your Form(s) W-2, or other statements. . . . . . .
6.
Tax Forgiveness Credit. Read the instructions.
Unmarried or Separated
Married
RESET BOTH BUTTONS
7a. Filing Status from your PA Schedule SP
7b. Total Eligibility Income. . . . . . . . . . . . . . . .
7b.
From your PA TeleFile Schedule SP, Line 10.
8. Tax Forgiveness Credit. From your PA TeleFile Schedule SP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8.
9. Total Payments and Credits. Add Lines 6 and 8. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9.
10. TAX DUE. If Line 5 is more than Line 9, enter the difference here. . . . . . . . . . . . . . . . . . . . . . . . . .
10.
Side 1
EC
OFFICIAL USE ONLY
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