2009 Instruction For Filing Form 214 (Page 5 of 5) in pdf

York Adams Tax Bureau

NAME: ______________________________________

Schedule M Worksheet

SSN: _____________________________________

1. This Schedule M is to be completed ONLY by taxpayers who lived in the Bermudian Springs School District during

all or any number of months from July 1, 2009 through December 31, 2009.

2. When completing Schedule M use only full months as follows: Your residence on the 15

of the month determines which

taxing municipality and school district are entitled to the tax for that month. If you lived in another state or taxing

authority during 2009, your tax liability for the York Adams Tax Bureau tax return will be based on your earnings

only for those months you lived in the YATB area. Prorate your W-2 earnings, expenses, profit or loss according

to the number of months in each column.

(A) From January 1, 2009 through June 30, 2009, enter how many months you lived in Bermudian Springs School

District: ______. (Enter here and at the top of Column (A) below).

(B) From July 1, 2009 through December 31, 2009, enter how many months you lived in Bermudian Springs School

District: ______. (Enter here and at the top of Column (B) below.

Springs School District: ______. (Enter here and at the top of Column (C) below. NOTE: If you lived outside

of the YATB taxing area during 2009, you will need to file a second local tax return with other tax bureau

where you resided for that time period. The total months of (A), (B) and (C) above MUST equal 12.

COLUMN A

COLUMN B

COLUMN C

TOTAL

(Enter on

Form 214)

Number of months from A, B and C above

1. W-2 earnings

2. Less employee business expense

3. Other taxable earned income

4. Total taxable earned income

5. Net profit from business, farm or profession

6. Net loss from business, farm or profession

7. Total taxable net profit (subtract line 6 from line 5)

8. Total taxable earned income and net profit (add

lines 4 & 7)

9. Tax Liability:

Column A – line 8 multiplied by 1% (.01)

Column B – line 8 multiplied by 1.7% (.017)

Column C – line 8 multiplied by the applicable tax

rate for the municipality where you resided (see

instructions).

3. The TOTAL Column is the total of columns A, B & C. These figures are to be entered in the corresponding lines on Form

#214, earned income tax return.

2009 Instruction For Filing Form 214 Page 5