Resident Exemption Certificate - City Of Pittsburgh And School District Of Pittsburgh

CITY OF PITTSBURGH and SCHOOL DISTRICT OF PITTSBURGH

RESIDENT EXEMPTION CERTIFICATE

EMPLOYER

____________________________________________

EMPLOYER ADDRESS ____________________________________________

I herby inform you that I became a resident of the CITY OF PITTSBURGH on _____ / _____ / _____ and have a

liability to pay and EARNED INCOME TAX to the City and/or School District of Pittsburgh.

EMPLOYEE

____________________________________________

EMPLOYEE ADDRESS ____________________________________________

EMPLOYEE SOCIAL SECURITY NUMBER _____________________________

If you are withholding for another Township, Borough, or Municipality please stop and direct the withholdings to

the City of Pittsburgh.

________________________________________________

_____________________

CITY OF PITTSBURGH TAX COLLECTOR’S SIGNATURE

DATE

414 GRANT ST PITTSBURGH PA 15219

412-255-2544

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Parent category: Financial