Annual Reconciliation Of 2014 Employee Earnings Tax - City Of Philadelphia
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SOCIAL SECURITY NUMBER
CITY OF PHILADELPHIA
ANNUAL RECONCILIATION OF 2014
0
2
1
4
EMPLOYEE EARNINGS TAX
DUE DATE APRIL 15, 2015
Do not file this return if Philadelphia wage tax was
Taxpayer Name and Address
withheld on all compensation (Line 12 = Line 13).
File a Change Form to cancel this account.
If wage tax was overwithheld by your employer, do
not file this return. File the Employee Wage Tax
Refund Petition.
Download forms at
-
-
m m
d d
y y y y
To cancel this account enter the termination date AND file a CHANGE
If this is an amended return place an "X" here:
YOU MUST USE THE CHANGE FORM TO REPORT A CHANGE OF ADDRESS.
,
,
.00
1. Gross Compensation received in 2014. Enclose 2014 W-2 form(s)........................................1.
,
,
.00
2. Non-taxable gross compensation from Page 2, Line 5............................................................2.
.00
,
,
3. Gross taxable compensation (Line 1 minus Line 2).................................................................3.
4. Taxable Gross Compensation received by a resident of Philadelphia
.00
,
,
January 1, 2014 to June 30, 2014..........................................................................................4.
,
,
.00
5. Tax Due (Line 4 times .03924).................................................................................................5.
6. Taxable Gross Compensation received by a resident of Philadelphia
,
,
.00
July 1, 2014 to December 31, 2014........................................................................................6.
,
,
.00
7. Tax Due (Line 6 times .03920).................................................................................................7.
8. Taxable Gross Compensation received by a nonresident of Philadelphia
,
,
.00
January 1, 2014 to June 30, 2014..........................................................................................8.
,
,
.00
9. Tax Due (Line 8 times .03495).................................................................................................9.
10. Taxable Gross Compensation received by a nonresident of Philadelphia
,
,
.00
July 1, 2014 to December 31, 2014......................................................................................10.
,
,
.00
11. Tax Due (Line 10 times .034915)............................................................................................11.
.00
,
,
12. Total amount of Tax Due (Add Lines 5, 7, 9 and 11)..............................................................12.
13. Any Philadelphia wage tax withheld by employer per enclosed W-2 forms.
,
,
.00
If Line 13 is equal to or greater than Line 12, STOP HERE! Do not file this return.........13.
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,
.00
14. Net Tax Due (Line 12 minus Line 13.)....................................................................................14.
15. Tax that you, not your employer, previously paid for 2014.
,
,
.00
(Not included on W-2 forms)..................................................................................................15.
16. ADDITIONAL TAX DUE If Line 14 is greater than Line 15, enter here
,
,
.00
and in the Tax Due box of the Payment Coupon ......,............................................................16.
OVERPAYMENT OPTIONS If Line 14 is less than Line 15, enter the amount to be:
,
,
.00
17A. REFUNDED. Do not file a separate Refund Petition......................................................17A.
.00
,
,
17B. APPLIED to the 2015 Earnings Tax Return........................................................................17B.
If claiming a refund on line 17A, W-2 forms must accompany this return. Do not file a separate Refund Petition.
Under penalties of perjury, as set forth in 18 PA C.S. §§ 4902-4903 as amended, I swear that I have reviewed this return
and accompanying statements and schedules, and to the best of my knowledge and belief, they are true and complete.
Taxpayer Signature________________________________________ Date_______________________Phone #_________________________
Preparer Signature_________________________________________ Date_______________________Phone #_________________________
Page 1
0214 4-15-2015
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