Form Wt-1s - Employer Quarterly Withholding & Reconciliation - 2004

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WT-1S 2004
EMPLOYER QUARTERLY
WITHHOLDING & RECONCILIATION
CFD
City of Pittsburgh
School District of Pittsburgh
and
Rev 09/03
FOR OFFICIAL USE ONLY
Amended Return ( )
Tax Return No Longer Needed ( )
CITY ID
FEDERAL ID
TAX PERIOD
QUARTER
SIGNATURE______________________________________________
Due on or before
TITLE ___________________________DATE___________________
PHONE __(__________)_____________________________________
PREPARER’S NAME_______________________________________
PREPARER’S PHONE__(_________)__________________________
I hereby certify, swear and aver that all statements herein are true and correct to the best of my
knowledge and belief, being duly apprised of my duty under the law to submit honest and
complete information or be subject to the penalties provided by law.
Make name/address corrections above
MAKE SURE YOUR SIGNATURE AND DATE APPEAR ABOVE
USE BLACK INK ONLY ON THIS FORM
COLUMN B
COLUMN C
SCHOOL TAX 2%
NON-RESIDENT OF PA OR U.S. 1%
1.
QUARTERLY TAXABLE WAGES
2
. ADJUSTMENT OF WAGES
Include a detailed explanation
3. TAXABLE WAGES THIS QUARTER
Subtract line 2 from line 1
4. TAX DUE ON WAGES
Multiply line 3 by rate for column
LINES 5, 6 AND 7 ARE FOR MONTHLY FILERS ONLY. Employers who do not file monthly go to line 8.
5. TAX WITHHELD and DEPOSITED
st
for 1
MONTH of this QUARTER
6. TAX WITHHELD and DEPOSITED
nd
for 2
MONTH of this QUARTER
7. TOTAL - FIRST TWO MONTHLY
DEPOSITS Add line 5 and line 6
8. BALANCE DUE WITH THIS
RETURN Subtract line 7 from line 4
TOTAL 6% - If Applicable
9. PENALTY and INTEREST
City Penalty 5% (0.05) – City Interest 1% (0.01)
Penalty and Interest per month
If Applicable
10. SUBTOTAL
Add line 8 and line 9
11.
TOTAL REMITTANCE WITH THIS RETURN
.
Make check payable to: TREASURER, CITY OF PITTSBURGH – DO NOT SEND CASH
Mail to: SPORTS WAGE TAX DUE – 414 GRANT ST RM 206 – PITTSBURGH PA 15219-2476
A $30.00 fee will be assessed for any check returned from the bank for any reason.
For assistance call 412-255-2523

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