Amended Final Return For Earned Income Tax For The Year 2009

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Berks Earned Income Tax Bureau
AMENDED
2009
If current address is different than above please indicate new address
New address:
DO NOT ROUND OFF
REFER TO ORIGINAL INSTRUCTIONS
Original Amount
Correct Amount
Net
Change
,
1.
Earned Income from W-2(s) (Both spouses)
!
,
2.
Less:
Allowable Unreimbursed employee business expenses
,
,
3.
Sub-total
(Line 1 minus Line 2)
!
,
,
4. Other earned income (See instructions)
¡
,
5. Net profit from a business, farm, profession, partnership, etc.
6. Net losses from a business, farm, profession, partnership, etc.
(limited to net profit on line 5)
,
7.
TOTAL TAXBLE EARNED INCOME
(add Lines 3 ,4 & 5 minus 6)
,
8.
Total Local
Income Tax
¡
9.
Enter Total
1 % Tax shown on W-2s..
¡
10. 2009 estimated payments plus out of state tax credit,
i
¡
plus Philadelphia tax paid
,
11.
Add lines 9 and 10
TOTAL CREDITS
¡
,
12.
Enter unpaid balance
DO NOT ROUND OFF
13. Enter refund due here
¡
I
,
14. Interest and penalty (see instructions)
,
15. Pay balance due (line 12 plus line 14)
I
TOl AL AMOUN i S Of~ I FSS THAN S1 00 NFFD NOT Bi fOAID NOR Will THEY BE REFUNDED
Make Checks payable to "Berks EIT Bureau"
I DECLARE UNDER PENALTIES PROVIDED BY LAW, THAT THIS RETURN HAS BEEN EXAMINED BY ME AND IS, TO THE BEST OF MY KNOWLEDGE,
A COMPLETE RETURN.
Your signature
(spouse's signature, if applicable)
Date
Your phone number
Tax Preparer's Signature
INSTRUCTIONS: Attach a copy of the original filing and all supporting documents
EXPLANATION OF CHANGES:
(If additional space is needed, attach separate sheet)

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