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Final Return For Earned Income Tax For The Year 2005 - Berks Earned Income Tax Bureau Form Page 2

If you have moved during the tax year, list the address(es) and month(s) below:

Address/City/State/Zip

Township/Boro

From

Pro-rated Tax Return: If you moved into or out of our taxing jurisdiction, you will be required to complete the following

worksheet before preparing the tax form. Declare only those wages earned and tax withheld, while a Berks EIT area resident.

Use only the Berks EIT portion of the worksheet below on lines 1 and 9 of reverse side.

Proration Worksheet

Berks EIT portion

Other collector portion

Employer's Name / Self-employed Earnings

Total Wages

Tax Withheld

Total Wages

Tax Withheld

Philadelphia Tax Credit: One person's Philadelphia wage tax credit may not be used to offset his/her spouse's tax liability.

Credit can only be taken for either the amount of tax paid to Philadelphia or the individual's tax liability, whichever is less.

Use only the Allowable Credit of the worksheet below on line 10 of reverse side.

Individual's

Employer's Name

Taxable Wage

Phila. Tax

1% Liability

Allowable Credit

Out-of-State Credit: One person's Out-of-State tax credit may not be used to offset his/her spouse's tax liability.

Credit can only be taken for the lesser of 1% of the Out-of-State wages or the difference between Line 3 and Line 5 of

PA Schedule G. The overpayment in one state cannot be used to offset the underpayment from another state.

Use only the Allowable Credit of the worksheet below on line 10 of reverse side. A copy of the applicable Schedule G(s)

must be attached.

PA Schedule G

1% of Individual's

Out-of-State Credit

Taxable Wage

Credit Available

Out-of-State Wages Allowable Credit

Final Return For Earned Income Tax For The Year 2005 - Berks Earned Income Tax Bureau Form Page 2