Estimated Payment For Erned Income Tax - Berks Earned Income Tax Bureau - 2012
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1
2Berks Earned Income Tax Bureau
920 Van Reed Road, Wyomissing, PA 19610
Telephone: 610-372-8439 Toll Free: 1-855-372-8439 Fax: 610-372-1102
2012
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5
ESTIMATED
If current address is different than above please indicate new address
New address:
ESTIMATED
PAYMENT
Taxoaver A
Spouse B
PLEASE SELECT THE APPROPRIATE BOX
Taxable Income
Tax Rate
Equals Tax Due
Equals Tax Due
NON-READING RESIDENT
X (times)
1.0%
READING RESIDENT
X (times)
3.4%
READING DISTRESSED
X (times)
0.1%
AMOUNT OF ESTIMATED PAYMENT INCLUDED
N1ake Checks payable to "Berks EIT Bureau"
1 OJ 1\1 ¡\NJUN rs (JI I I ::s IIIflN 51 or) ~~I i !l NOT B~ PAID NOI~ Viii i THE:Y HI i,rf UNUl IJ
I DECLARE, UNDER PENALTIES PROVIDED BY LAW, THAT THIS RETURN HAS BEEN EXAMINED BY ME AND IS, TO THE BEST OF MY KNOWLEDGE,
A COMPLETE AND ACCURATE RETURN.
Your signature
Spouse's signature
Date
Your phone number
Tax Preparer's Signature
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