Annual Reconciliation Of 2013 Employee Earnings Tax - City Of Philadelphia

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DUE DATE APRIL 15, 2014
CITY OF PHILADELPHIA
6
0
1
3
ANNUAL RECONCILIATION OF 2013
SOCIAL SECURITY NUMBER
EMPLOYEE EARNINGS TAX
Taxpayer Name and Address
Do not file this return if Philadelphia wage tax was withheld on
all compensation (Line 12 = Line 13). File a Change Form to
cancel this account. If wage tax was overwithheld by your
employer, do not file this return. File the Employee Wage
Refund Petition. The Change Form and Employee Refund
Petition can be downloaded from our web site.
YOU MUST USE THE CHANGE FORM TO REPORT A CHANGE OF ADDRESS.
If this is an amended return
mm-dd-yyyy
place an "X" here:
To cancel this account enter the termination date AND file a CHANGE FORM.
.00
1. Gross Compensation received in 2013. Enclose 2013 W-2 form(s)...........................................1.
.00
2. Non-taxable gross compensation from Page 2, Line 5................................................................2.
.00
3. Gross taxable compensation (Line 1 minus Line 2).....................................................................3.
4. Taxable Gross Compensation received by a resident of Philadelphia
.00
January 1, 2013 to June 30, 2013..............................................................................................4.
.00
5. Tax Due (Line 4 times .03928).....................................................................................................5.
6. Taxable Gross Compensation received by a resident of Philadelphia
.00
July 1, 2013 to December 31, 2013............................................................................................6.
.00
7. Tax Due (Line 6 times .03924).....................................................................................................7.
8. Taxable Gross Compensation received by a nonresident of Philadelphia
.00
January 1, 2013 to June 30, 2013..............................................................................................8.
.00
9. Tax Due (Line 8 times .034985)...................................................................................................9.
10. Taxable Gross Compensation received by a nonresident of Philadelphia
.00
July 1, 2013 to December 31, 2013.........................................................................................10.
.00
11. Tax Due (Line 10 times .03495).................................................................................................11.
.00
12. Total Tax Due (Add Lines 5, 7, 9 and 11)..................................................................................12.
13. Any Philadelphia wage tax withheld by employer per enclosed W-2 forms.
.00
If Line 12 is equal to Line 13, STOP HERE! Do not file this return.....................................13.
.00
14. Net Tax Due (Line 12 minus Line 13. If negative number, enter zero)......................................14.
15. Tax that you, not your employer, previously paid for 2013.
.00
(Not included on W-2 forms)......................................................................................................15.
16. ADDITIONAL TAX DUE If Line 14 is greater than Line 15, enter here
.00
and in the Tax Due box of the Payment Coupon.......................................................................16.
OVERPAYMENT OPTIONS If Line 14 is less than Line 15, enter the amount to be:
.00
17A. REFUNDED. Do not file a separate Refund Petition..........................................................17A.
.00
17B. APPLIED to the 2014 Earnings Tax Return............................................................................17B.
If claiming a refund on line 17A, W-2 forms must accompany this return. Do not file a separate Refund Petition.
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 #_________________________
6013 Internet 9-7-2013
Page 1

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