Employer Annual Earned Income Tax Reconciliation Form - Lancaster Country 2009

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LANCASTER COUNTY TAX COLLECTION BUREAU
1845 William Penn Way Suite 1, Lancaster, PA 17601-6713
Telephone: (717) 569-4521
2009 EMPLOYER ANNUAL
EARNED INCOME TAX RECONCILIATION FORM
INSTRUCTIONS FOR COMPLETING THIS FORM
Step 1 - DETERMINE METHOD OF SUBMITTING RECONCILIATION INFORMATION:
Employers are required to submit employee earned income tax information in one of the approved formats
listed on the reverse side of this form.
Step 2 - COMPLETE INFORMATION ON THE FORM BELOW USING BLACK OR BLUE INK ONLY.
1. Enter the total of the Earned Income Tax Withheld in Section 1 below.
2. Check the appropriate box in Section 2 indicating the filing method being used.
Step 3 - MAILING INSTRUCTIONS:
Mail or deliver this Annual Reconciliation Form, along with the required employee information to:
Lancaster County Tax Collection Bureau
Employer Department
1845 William Penn Way Ste 1
Lancaster PA 17601-6713
IF AN ACCOUNTING OFFICE OR PAYROLL SERVICE IS RESPONSIBLE FOR REMITTING YOUR END-OF-YEAR
TAX INFORMATION, PLEASE FORWARD THIS FORM TO THEM.
2009
Lancaster County Tax Collection Bureau
Due: March 1, 2010
Earned Income Tax Reconciliation Form
EIN: ______________________ EMPLOYER: ________________________________________________________
ACCT. NO: ________________ CONTACT NAME: __________________________ PHONE: ________________
Note: Please
DOLLARS
CENTS
Section (1
)
Enter the total amount of Earned Income Tax
do not remit
withheld.
$
payment with
this form.
Section (2)
Check appropriate box:
ACCEPTABLE FILING FORMATS.
q
q
LCTCB Excel Spreadsheet
MEDIA:
CD-ROM
q
3-1/2" Disk
q
EFW2 (Formerly MMREF-1)
MEDIA:
CD-ROM
3-1/2" Disk
q
q
Note: W2 paper forms only accepted for 25 or less employees.
LCTREGEN9

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