Form Bpt-Ez - Business Privilege Tax - 2004
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1
2MAKE NO MARKS IN THIS AREA
CITY OF PHILADELPHIA
2004
0 1 0 4
BUSINESS PRIVILEGE TAX - EZ
BPT-EZ
DUE BY APRIL 15, 2005
DO NOT STAP LE THIS RETURN
CITY ACCOUNT NUMBER
TAXPA Y ER NAME & A DDRESS
PLACE LA BEL HERE
Always enter your account number
FEDERA L IDENTIFICA TION NUMB ER
-
Us e the Change Form to report an address change. Do not
SOCIA L SECURITY NUMBER
make changes on the above label. See Instruction Sheet I.
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-
→
If your business terminated in 2004, place a zero on Line 4.
If your business terminated in 2004,
Indicate the termination date in the space provided.
enter the termination date here:
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-
m
m
d
d
y
y
y
y
COM PUTATION OF TAX DUE OR REFUND
00
,
,
.
1. NE T INCOME PORTION OF TA X (from Page 2, Line 5).
If there is no tax due, enter "0"............................ ............... ............... ............... ............1.
00
,
,
.
2. GROSS RECEIPTS PORTION OF TA X (from Page 2, Line 8).
If there is no tax due, enter "0"............................ ............... ............... ............... ........... 2.
00
,
,
.
3. TA X DUE f or the 2004 Business Privilege Tax (Line 1 plus Line 2)................... ...........3.
00
,
,
.
4. M ANDATORY 2005 BPT Es timated Payment (repeat Line 3)....................... ............4.
00
,
,
.
5. Total Due by 4/15/2005 (Line 3 plus Line 4)............... ............... ............... ............... .....5.
00
,
,
.
6. Es timated payments and other credits:
a. Credit f rom overpayment of 2003 or 2004 Net Prof its Tax................ ............... .......6a.
00
,
,
.
b. Include any estimated and/or extension payments of 2004 BPT previously
made, and any credit from overpayment of the 2003 BPT return.................. ...6b.
00
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c. Total Payments and Credits (Line 6a plus 6b)........................ ............... ............... .6c.
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.
00
7. Net Tax Due (Line 5 less Line 6c)....................... ............... .............................. ............7.
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,
.
00
8. Interest and Penalty
(Cumulative % from Instruction Sheet III multiplied by Line 7)................. ............... .....8.
,
,
.
00
9. TOTAL DUE including Interest and Penalty (Line 7 plus Line 8).
Use Payment Coupon, make check payable to: "City of Philadelphia".................9.
,
,
.
00
10. Overpayment options. If Line 6c is larger than Line 5, enter:
a. A mount to be ref unded to taxpayer. Do not file a separate Re fund Petition....10a.
,
,
.
b. A mount of overpayment to be applied up to the tax due to the
00
2004 Net P rofits tax.................... ............... ............... ............... ............... .............10b.
,
,
.
c. Amount of overpayment to be applied to the
00
2005 Business Privilege tax............................ ............... ............... ............... ........10c.
Under penalties of perjury, as set forth in 18 Pa. C.S . §§ 4902-4903 as amended, I swear that I have reviewed this return and
accompanying statements and schedules, and to the best of my knowledge and belief , they are true and complete.
Taxpayer Signature_______________________________________
Date________________ Phone #____________________
Preparer Signature________________________________________ Date________________ Phone #____________________
DO NOT STAPLE THIS RETURN
Page 1
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