Bellwood-Antis School District And Municipality Individual Return Form - Bellwood-Antis School District Tax Office Page 2
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2INSTRUCTIONS FOR FILING FINAL RETURN FOR EARNED INCOME AND NET PROFITS TAX
Residents of Bellwood Borough, and Antis Township will remit 1% tax with this return-1/2% for school purposes and 1/2% for
township and borough purposes.
WHO MUST FILE - All individuals who have taxable earned income and/or net profits and resided in Antis
Township or Bellwood Borough. If you receive a form, it must be returned even if there are no earnings to
report. Failure of a taxpayer to receive a tax form shall not excuse the taxpayer from filing a return, or from
paying any tax due. Failure to file your return may subject you to a fine up to $500. Forms are available at the
tax office, or can be mailed upon request.
Note: The taxable period for this return is from January 1 through December 31, or any portion while a resident
of this district. Any individual who resided in the district for part of the year must pay based on the time
domiciled in the district.
TAXABLE INCOME (Use these items)
1. WAGES
6. FEES
2. SALARIES
7. NET PROFIT OF BUSINESS, PROFESSION
3. COMMISSIONS
AND OTHER ACTIVITY (SUBMIT SCHEDULES)
4. BONUSES
8. INCENTIVE PAYMENTS
5. TIPS-RECEIVED
9. SICK OR DISABILITY BENEFITS PAID BY EMPLOYER
NON-TAXABLE INCOME (Do Not Use)
8. DEATH BENEFITS
1. OLD AGE BENEFITS
2. RETIREMENT PAY
9. PROCEEDS OF INSURANCE POLICIES
10. GIFTS OR BEQUESTS
3. PENSION
11. INTEREST
4. SICK OR DISABILITY PAID
12. PUBLIC ASSISTANCE OR UNEMPLOYMENT COMPENSATION
THROUGH THIRD-PARTY INSURANCE
13. CLERGY HOUSING
5. CAPITAL GAINS OR LOSSES
6. ACTIVE MILITARY SERVICE PAY OR
14. QUALIFIED SECTION 125 PLAN DEDUCTIONS
BONUSES FOR ACTIVE MILITARY SERVICE
7. INCOME FROM STOCKS, TRUSTS, AND RENTAL OF DWELLINGS OWNED BY INDIVIDUALS NOT
LICENSED (OR CONDUCTING A BUSINESS) AS REALTORS BY THE COMMONWEALTH OF PENNSYLVANIA.
IMPORTANT INFORMATION
March 6, 1989 Supreme Court decision (O’Reilly vs Fox Chapel Borough and School District) now allows a taxpayer to
offset a net loss from a business (professional or farm) against earned income (as reported on a W-2). However, a
taxpayer is still not permitted to offset a net loss from one business against a net profit of another business.
If you should receive more than one tax return as a result of moving or marriage please return both forms to us, using the
correct form for filing and marking “duplicate” on the incorrect form.
A service fee of $20.00 will be assessed on all checks returned.
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