Non-Resident Employee Earnings Allocation Form

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NON-RESIDENT EMPLOYEE EARNINGS ALLOCATION
AND/OR DEDUCTIBLE EMPLOYEE BUSINESS EXPENSES REPORT
Read Instruction Sheets A and B before completing this report.
• Re sidents and non-residents of Philadelphia must complete this report to calculate deductible employee business
e xpenses. Certain non-residents must complete this report to calculate non-taxable compensation.
• If wage tax was overwithheld by your employer, do not file this return. File the Employee Wage tax Re fund Petition.
EMP LOY ER
PLACE OF EMPLOYMENT
SOCIAL SECURITY NUMBER
-
-
EMPLOY ER FEDERAL IDENTIFICATION NUMBER
(From Form W-2)
-
IF PARTIAL YEAR:
From__________ _______ To_________________
COM PUTATION OF NON-TAXABLE COM PENS ATION AND/OR ALLOWABLE EXPE NSES
FOR EM PLOYEES PAID ON A SALARY BASIS
1. GROSS S ALARY.................. ............... ............... .............................. ............... ............... .............1.
,
,
. 0 0
A . Number of compensated days/hours................. ............... ............... ............... ............... .......1A .
Days/Hours
B. Compensated non-workdays/hours (Total of vacation, holiday and sick days/hours)............1B.
Days/Hours
C. Number of actual workdays/hours. (Line 1A minus 1B).................... ............... ............... ......1C.
Days/Hours
D. Number of actual days/hours worked outside Philadelphia in 1C............... ............... ............1D.
Days/Hours
%
E. Percentage of time worked outside Philadelphia (Line 1D ÷ 1C)............. ............... ...............1E.
F. Non-taxable compensation earned outside of Philadelphia (Line 1 X Line 1E )...................... 1F.
,
,
. 0 0
G. Deductible non-reimbursed employee business expenses
,
,
. 0 0
f rom Worksheet Line 3, Instruction Sheet B........ .............................. ............... ............... ......1G.
H. Non-taxable income and or deductible employee business expenses
,
,
. 0 0
(Line 1F + Line 1G).............. ............... .............................. ............... ............... ............... .......1H.
COM PUTATION OF NON-TAXABLE COM PENS ATION AND/OR ALLOWABLE EXPE NSE S
FOR EM PLOYEES PAID ON A COMMISSION BASIS
2. GROSS COM M ISSION.... ............... ............... ............... ............... ............... ............... ..................2.
,
,
. 0 0
A . Total sales...................... ............... ............... ............... ............... ............... ............... ............2A .
,
,
. 0 0
B. Sales outside of Philadelphia....... ............... ............... ............... ............... ............... ..............2B .
,
,
. 0 0
C. Percentage of sales outside of Philadelphia. (Line 2B ÷ Line 2A )........................ ............... .2C.
%
D. Non-taxable comm issions earned outside of Philadelphia
,
,
. 0 0
(Line 2 X Line 2C)........ ............... ............... ............... ............... ............... ............... ............... 2D.
E. Deductible non-reimbursed employee business expenses
,
,
. 0 0
f rom Worksheet Line 3, Instruction Sheet B........ ............... ............... ............... .....................2E.
F. Non-taxable income and/or deductible employee business expenses
,
,
. 0 0
(Line 2D + Line 2E).............. ............... ............... .............................. ............... ............... .......2F.
3. TOTAL NON-TAXABLE COM PENS ATION (Add lines 1H and Line 2F.
,
,
. 0 0
Enter here and on Line 2 of the return.................... .............................. ............... ............... .....3.
,
,
. 0 0
4. NE T TAXABLE COM PENSATION (Line 1 plus Line 2 M INUS Line 3)
Residents enter Line 4 on Page 1, Line 4; Non-residents on Page 1, Line 6.........................4.
Page 2

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