Form 531 - Final Earned Income Tax Return - Cumberland County Page 2
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2MOVE INFORMATION: The earned income tax is based on your residence or domicile. If you and/or your spouse have moved during the tax
year, please complete the move information below. If you need additional space, please use a copy or attach a separate page. Prorate income
and tax withheld by the number of months in each municipality using the employer/source of income information below.
If you and/or your spouse have moved from one CCTB member municipality to another CCTB member municipality during the tax year, you do
not need to file a second earned income tax return as long as the move information is provided below. Prorate earned income and tax withheld
by the number of months in each municipality using the work sheet below.
PLEASE NOTE: If you have moved from a non‐member municipality/school district or moved to a non‐member municipality/school district
during the year, you are required to file earned income tax returns with the Cumberland County Tax Bureau and with the tax collector for the
non‐member municipality/school district. Please provide a copy of the non‐member municipality/school district earned income tax return
along with the CCTB earned income tax return.
TAXPAYER A
# Of
Street Address
Resided From
Resided To
City/State/Zip
Municipality
Months
(NO P.O. Boxes)
(MMDDYYYY)
(MMDDYYYY)
Resided
EMPLOYER/SOURCE OF INCOME INFORMATION
State/Local
Local Tax
Employed
# Of
Wages
Employed To
Prorated
Prorated
Employer Name and Address
Withheld
From
Months
(W2 Box
(MMDDYYYY)
Earnings
Tax
(W2 Box 19)
(MMDDYYYY)
Employed
16/18)
TAXPAYER B
# Of
Street Address
Resided From
Resided To
City/State/Zip
Municipality
Months
(NO P.O. Boxes)
(MMDDYYYY)
(MMDDYYYY)
Resided
EMPLOYER/SOURCE OF INCOME INFORMATION
State/Local
Local Tax
Employed
# Of
Wages
Employed To
Prorated
Prorated
Employer Name and Address
Withheld
From
Months
(W2 Box
(MMDDYYYY)
Earnings
Tax
(W2 Box 19)
(MMDDYYYY)
Employed
16/18)
NON RECIPROCAL STATE/PHILADELPHIA CREDIT WORKSHEET: Actual income taxed by other state (income for which liability was calculated) as
shown on other state’s return or for Philadelphia credit as shown on W2 or as reported to the City of Philadelphia. Do not use business privilege
tax. Please note this credit cannot exceed your earned income tax liability on the income taxed by the other state. REQUIRED: You must attach
copies of other state’s non‐resident tax return along with a PA 40 and PA Schedule G or your out of state credit will be denied.
(1) Actual earned Income
_______________
(2) Local Tax Rate as specified on front of tax return
X__________%
(3) Local Tax Liability
________________
(4) Tax liability paid to other state Or Philadelphia (Philadelphia Credit: Lesser amount should be entered on line 12)
________________
(5) PA Income Tax (Line 1 X PA Income Tax Rate 3.07%)
________________
(6) Local Tax Credit (Line 4 minus Line 5) If Line 5 is more than Line 4 enter ZERO (0)
________________
(7) Enter lesser amount from Line 3 or 6
________________
(8) Enter amount on Line 12 of tax return
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