Final Return For Earned Income Tax - West Shore Tax Bureau Form 2002
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2WEST SHORE TAX BUREAU
3607 ROSEMONT AVENUE
CAMP HILL, PA 17001
2002 FINAL RETURN FOR EARNED INCOME TAX
INDIVIDUAL FILING ONLY – DO NOT JOINT FILE
REFERENCE NO.
PSD
OUR RECORDS INDICATE YOU ARE A RESIDENT OF:
SOCIAL SECURITY NUMBER
CODE
COLUMN 1
COLUMN 2
ACTIVITY FROM
ACTIVITY FROM
TOTAL
JAN 1 – JUN 30
JULY 1 – DEC 31
11. W-2 Earnings (Attach W-2’s)
12. Employee Business Expenses (Attach State
Schedule UE & Required Attachments)
13. Taxable W-2 Earnings (Subtract Line 2 from Line 1)
14. Other Taxable Earned Income (No Interest, Dividends or
Unemployment Benefits)
15. Total Taxable Earned Income Before Net
Profits (Losses) – (Add Lines 3 & 4)
16.
Net Loss from Self-employed business, profession, or farm
(Use Line 8 for any Net Profits) (Attach appropriate IRS Schedules)
17. Subtotal (Subtract Line 6 from Line 5)
If less than zero, enter zero.
18.
Net Profits from Self-employed business, profession, or farm (Use
Line 6 for any Net Losses) Attach Appropriate IRS Schedules
19. Total Taxable Earned Income and Net Profits
(Add Line 7 and 8)
1%
10A. Rate in effect (See instructions for rate for column 2)
10B. Tax Liability (Column 1 Line 9 x 10 A Column 1)
(Column 2 Line 9 x 10 A Column 2)
11. Credits:
A Tax withheld by employer (Form W-2)
B Quarterly Payments Made to WSTB
C Taxes Paid to Philadelphia and/or State
other than PA
D Total Credits (11A through 11C)
12. If Line 11D is larger than Line 10, enter refund due
here (If less than $1.00, Enter Zero)
13. If Line 10 is larger than Line 11D, pay unpaid
balance by April 15 (If less than $1.00, Enter Zero)
14. Add Interest and Penalty of 1% per month of Line
13 after April 15.
15. Pay Balance Due with the return (Line 13 plus Line 14)
15A.
Check if your balance due was caused by the employer withholding
tax at a rate less than levied in your resident school district.
MAKE CHECKS PAYABLE TO: WESTAB • PHONE 761-4900
FOR
TAX BUREAU COPY
OFFICE
USE
2002 FINAL RETURN FOR EARNED TAX
ONLY
TAX
DO NOT WRITE HERE
I declare, under penalties of law, that I have examined this return and accompanying
schedules and, to the best of my knowledge and belief, it is true, correct, and complete.
Your signature
Date
Phone #
Paid Preparer’s Name
Phone #
Did you move during the year? Yes
(Please complete residence schedule on next page) No
If you or your client had NO EARNED INCOME, please check the reason so that we may update our records:
Homemaker
Retired
Student
Disabled
Unemployed
Deceased
Other
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