School Income Tax Form - City Of Philadelphia - 2016
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1Your Social Security Number
CITY OF PHILADELPHIA
2016 SCHOOL INCOME TAX
2
9
1
6
DUE DATE: APRIL 18, 2017
Taxpayer Name and Address
Spouse's Social Security Number
File online or download forms at
DO NOT REPORT NEGATIVE NUMBERS ON THIS RETURN
YOU MUST USE THE CHANGE FORM TO REPORT A CHANGE OF ADDRESS.
If this is an amended return place an "X" here:
If you were a partial year resident in 2016,
-
-
-
-
m m
d d
y y
m m
d d
y y
refer to page 1 of instructions and enter dates of residency
to
-
-
m m
d d
y y y y
If you no longer have income subject to School Income Tax enter the termination date AND file a CHANGE FORM.
.00
1. Net Taxable Dividends (School Income Tax Regulation 203(a)).....................................1.
.00
2. Taxable Interest (Reg. 203(b)).........................................................................................2.
.00
3. "Subchapter S" Corporation Income Distribution (Regs. 202 and 203)...........................3.
.00
4. Limited Partnership Income (Reg. 203(i)). If loss, enter "0" (zero)..................................4.
.00
5. Taxable Income received by a Beneficiary of an Estate or Trust (Reg. 205)...................5.
6. Net Short Term Capital Gains (held 6 months or less) (Reg. 203(d) and 204(b)).
.00
If loss, enter "0" (zero)......................................................................................................6.
.00
7. Net Rental Income (Reg. 203(c)). If loss, enter "0" (zero)...............................................7.
.00
8. Other Taxable Income (Reg. 203(e, f, g and h))..............................................................8.
.00
9. Total Taxable Income (Add lines 1 through 8).................................................................9.
.00
10. Deductible Expenses (cannot exceed line 9) (Reg. 204(a))........................................10.
.00
11. Net Taxable Income (Subtract line 10 from line 9).........................................................11.
.00
12. Gross Tax Due (Multiply line 11 by .039004)................................................................12.
13. Credit from overpayment of prior year or tax previously paid
.00
with an extension coupon...............................................................................................13.
14. TAX DUE If Line 12 is greater than Line 13, enter the difference here
.00
and on the PAYMENT COUPON...................................................................................14.
OVERPAYMENT OPTIONS If Line 12 is less than Line 13, enter the amount to be:
.00
15A. REFUNDED. Do not file a separate Refund Petition.............................................15A.
OR
.00
15B. APPLIED to the 2017 School Income Tax..................................................................15B.
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 #_________________________
Spouse's Signature________________________________________ Date_______________________Phone #_________________________
Preparer Signature_________________________________________ Date_______________________Phone #_________________________
2916 7-27-2016
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