Final Return For Earned Income & Net Profit Tax For Year 2010

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Berks Earned Income Tax Bureau
AMENDED
2010
Your Social Security Number
Spouse's Social Security Number
Last Name
Your First Name & Middle Initial
Spouse s Last Name (IT amerent trom aoove)
It Joint Return, Spouse s First Name & Middle Initial
Physicai Kesiaent Aaaress (numoer ana street)
~ity, ::tate ana LiP t;ooe
AMENDED
If current address is different than above, please indicate new address
920 Van Reed Road, Wyomissing, PA 19610
Telephone: 610-372-8439 Toll Free: 1-855-372-8439 Fax: 610-372-1102
FINAL RETURN FOR EARNED INCOME & NET PROFIT TAX FOR THE YEAR 2010
AMENDED
New Address:
Tax a er A Amended
Souse B Amended
1. Earned Income from W-2(s) See Instructions
(Enclose W-2(s) Indicating all information from Box 1 through Box 20)
2. Less: Allowable Unreimbursed Employee Business Expenses (See instructions)
(Enclose PA UE and Page 1 of Form PA-40)
2
3. Other Earned Income (See instructions)
3
4. Sub-Total (Line 1 minus Line 2 plus Line 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)
4
7. TOTAL TAXABLE NET PROFIT (lines 5 minus 6)
NOT LESS THAN ZERO
8. TOTAL TAXABLE 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
10
11. 2010 0 estimated payments
2009 0 prior year credit
11
12. 0 Philadelphia Credit
o Out of State Credit
12
14. OverpaymenURefund (Line 13 minus 9)
If less than $1 - enter zero
13. Total Credits (Add Lines 10, 11 & 12)
15. Amount of overpayment to transfer to next year/transfer 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 April
15, 2011 (See instructions)
18. Interest after April
15, 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 PENALTIES PROVIDED BY LAW, THAT THIS RETURN HAS BEEN EXAMINED 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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