Final Return For Earned Income & Net Profit Tax For The Year 2010
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1
2Due Date:
Berks Earned Income Tax Bureau
2010
April 15, 2011
920 Van Reed Road, Wyomissing, PA 19610
Telephone: 610-372-8439 Toll Free: 1-855-372-8439 Fax: 610-372-1102
FINAL RETURN FOR EANED INCOME & NET PROFIT TAX FOR THE YEAR 2010
SEE REVERSE SIDE OF THIS FORM AND SEPARATE INSTRUCTIONS & DEFINITIONS SHEET
Your Social Secunty Number
Spouse's Social Secunty Number
Last Name
Your First Name & Middle Initial
I :spouse s Last Name (If difrent from abOve)
Ilf Joint Retum. Spouse s i-irst Name~ddle Initial
i..nysici Kesident Addres (number and street)
Ivity, :state and zip COe
i illS I~L fUl~N í,1f\Y 131
f II i L) CJN I lí'-I- Lf '.'jO\V Sf RK,f I i C, JU
II Cliireril andress IS (Iitlelt-iil triciri dbuve pIVdSI" IlicJlcatc: ~1(~'1 addiess
New Address:
Tax a er A
Souse B
1. Eamed Income from W-2(s) See Instructions
(Enclose W-2(s) Indicating all information fr Box 1 through Box 20)
2. Less: Allowable Unreimbursed Employee Business Expenses (See instructions)
(Enclose PA UE and Page 1 of FORn PA-4)
2
3
4
3. Other Earned Income (See instructions)
4. Sub- Total (Line 1 minus Line 2 plus Une 3 Not less than zero
5. Net Profits from a business. farm. profession. partnership, etc.
(Enclose PA Schedules
6. Net Losses from a business, farm. profession. partnership. etc.
(Enclose PA Schedules) (Limited to net profits on line 5)
7. TOTAL TAXBLE NET PROFIT (lines 5 minus 6
NOT LESS THAN ZERO
8. TOTAL TAXBLE EARNED INCOME (add Lines
4 & 7)
9. Total Local
Income Tax (Line 8 X Tax Rate)
10. Enter Total Local
Income Tax withheld on W-2s" (Enclose W.2's. Copies ok)
DO NOT INCLUDE PHILADELPHIA OR OUT OF STATE TAX
9
11. 2010 0 estimated payments
2009 0 pnor year credit
10
11
12
12. 0 Philadelphia Credit
o Out of State Credit
13. Total Credits (Add Lines 10.11 & 12)
14. OverpaymenVRefund (Line 13'minus 9)
If less than $1 - enter zero
15. Amount of overpayment to transfer to next yearltransfer to spouse. 0 Next year 0 Spouse
16. Tax Balance Due (Line 9 minus line 13)
If less than $1 . enter zero
17. Penalty after Apn115. 2011 (See instructions)
18. Interest after Apn115, 2011 (See instructions)
19. Total Amount Due (Add lines 16, 17 and 18)
DO NOT ROUND OFF
Make Checks payable to "Berks EIT Bureau"
o CHECK HERE IF PAYING BY CREDIT CARD
I DECLARE. UNDER PENATIES PROVIDED BY LAW, THAT THIS RETURN HAS BEEN EXMINED BY ME AND IS. TO THE BEST OF MY KNOWLEDGE,
A COMPLETE AND ACCURATE RETURN.
Your signature
Spouse's signature
Date
Your phone number
Tax Preparer's Signature
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