City Of Philadelphia School Income Tax Form - 1999

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CITY OF PHILADELPHIA
SCHOOL INCOME TAX
1999
Due Date: April 17, 2000
Your Social Security #
If this is an amended return,
check here: ..................
SEE INSTRUCTIONS ON BACK
Check here if you have never filed a School Income
Tax Form ..................................._______
If a final return, enter cancellation date: ________
Enter any corrections to preprinted information:
New Name: __________________________________________
Social Security number: ______-____-______
New Address: ________________________________________
____________________________________________________
1.Net Taxable Dividends (see instructions) ....1.
2. Taxable Interest (see instructions) .........2.
3. “S” Corporation Distributions ...............3.
4. Limited Partnership Income (if “loss”, “0”) .4.
5. Taxable Income Received as a Beneficiary
from an Estate or Trust (see instructions) ..5.
6. Net Short Term Capital Gains (if “loss”, “0”)
(Held 6 months or less) .....................6.
7. Net Rental Income (if “loss”, “0”) ..........7.
8. Other Taxable Income (see instructions) .....8.
9. Total Taxable Income (add lines 1 through 8) 9.
10.Deductible Expenses (see instructions).....10.
11.Total Taxable Income (line 9 less line 10).11.
12.Tax Due (4.6135% of line 11)...............12.
DO NOT DETACH
NAME:
SOCIAL SECURITY #:
YEAR:
ADDRESS:
CITY:
STATE:
ZIP:
School Income Tax
(A.) Tax due
(B.) Interest & Penalty
(C.) Total Due (block “A” & “B”)
(Line 12 above)
(SEE CHART ON BACK)
Make Check Payable to “City Of Phila.”
1999
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.
Signature: ____________________________________________ Date: _____________ Phone: ______________________
Preparer’s Signature: _________________________________ Date: _____________ Phone: ______________________
W

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