Amended Final Return For Earned Income Tax Form - Berks Earned Income Tax Bureau

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Berks Earned Income Tax Bureau
AMENDED
lax
Year
I
If current address
is different than above
please
indicate
new
address
New address:
DO NOT ROUND OFF
REFER TO ORIGINAL INSTRUCTIONS
Oriainal Amount
Correct Amount
Net
Change
1.
Earned Income from W-2(s) (Both spouses)
2.
Less:
Allowable Unreimbursed employee business expenses
3.
Losses from a business, farm, profession, partnership, etc.
4. Sub-total (Line 1 minus Line 2 minus Line 3 )
5. Other earned income (See instructions)5
,
6. Net profit from a business, farm, profession, partnership, etc.
7.
TOTAL TAXBLE EARNED INCOME
(add Lines 4, 5 & 6)
8.
Total Local
Income Tax
9.
Enter Total
1 % Tax shown on W-2s"
10.
í
estimated payments, .. plus out of state tax credit,
plus Philadelphia tax paid í
11.
Add lines 9 and 10
TOTAL CREDITS
12.
Enter unpaid balance
DO NOT ROUND OFF
,
13. Enter refund due here
14. Interest and penalty (see instructions)
15. Pay balance due (line 12 plus line 14)
TOTAL AMOUNT S OF LESS THAN 51 00 NEED NOT f3E IOAID NOR VJILL rHEY BE REFUNDED
Make Checks payable to "Berks Ell 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 fiing and all supporting documents
EXPLANATION OF CHANGES:
(If additional space is needed, attach separate sheet)

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