Pennsylvania Telefile Worksheet
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1Pennsylvania TeleFile Worksheet
PAGE 5
PART 1
IDENTIFICATION INFORMATION from the preprinted label provided with this booklet. Your PIN(s) Number(s) is (are) above your label.
Your SSN(s) is (are) from your 1997 PA tax return as it was received by the Department of Revenue.
First Personal
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1 First Social Security Number
Identification Number
Second (Spouse’s) Social
Second(Spouse’s) Personal
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Security Number (if Married)
Identification Number (if Married)
I
f married and filing jointly, the first SSN is the Social Security Number entered first on your 1997 PA tax return. The second (Spouse’s SSN) is the other Social Security
Number on your 1997 PA tax return. The format of your label is the way you filed your 1997 PA tax return.
PART 2
INFORMATION FROM EACH FORM W-2, WAGE AND TAX STATEMENT.
2 Number of Form(s) W-2
If more than 7, you may not use
TeleFile.
3 Enter amounts in whole dollars only. Round all amounts. If $0.50 or more, increase to the next whole dollar. If $0.49 or less, drop the cents.
a) Employer Identification Number
b) Taxable PA Compensation
c) PA Income Tax Withheld
d) Employee Expenses from
from box b on your Form W-2
from W-2, box 17
from W-2, box 18
PA TeleFile Schedule UE
1 st
$
$
$
x x
x x
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x x x x x x x
x x x x x x x
.00
.00
.00
$
$
$
2nd
x x
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x x x x x x x
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$
$
$
x x
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x x x x x x x
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.00
3rd
$
$
x x
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x x x x x x x
$
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4th
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$
$
x x
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x x x x x x x
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5th
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$
$
x x
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x x x x x x x
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.00
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6th
$
$
$
x x
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x x x x x x x
.00
.00
.00
7th
AMOUNTS YOU MUST ENTER. When instructed by TeleFile, you:
PART 3
$
.00
Enter your total PA taxable interest. See the instructions and PA TeleFile Schedule A.
$
.00
Enter your total PA taxable dividends. See the Instructions and the PA TeleFile Schedule B.
$
Enter your Nontaxable Income from Line 8 of your PA TeleFile Schedule SP.
.00
If you do not have income for these lines, enter zero.
You are now ready to use the TeleFile System. Call 1-888-4PA-FILE (1-888-472-3453).
PART 4
YOUR TELEFILE TAX RETURN. TeleFile will tell you these amounts after you enter the above information.
$
1 Total gross PA taxable compensation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
.00
2 Total allowable employee business expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
$
.00
$
3 Net taxable PA compensation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
.00
$
4 Total PA taxable income.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
.00
5 Your 1998 PA tax liability. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
$
.00
6 Your total PA income tax withheld. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
$
.00
$
7 Your 1998 PA Tax Forgiveness credit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
.00
PART 5
TAX DUE OR OVERPAYMENT
$
.00
8 Your 1998 PA tax due. You must pay your tax due by April 15, 1999. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Follow the instructions on your PA-V form on the insert. If you owe $1.00, or less, do not send a payment.
$
9 Your 1998 overpayment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
.00
If you want to donate all or a portion of your overpayment, if more than $1.00, listen carefully to the instructions for Lines 10
through 14. You must enter these amounts, otherwise you will receive a refund check.
$
10 Donation to the Wild Resource Conservation Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
.00
$
11 Donation to the U. S. Olympic Committee, PA Division. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
.00
12 Donation to the Organ Donor Awareness Trust Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
$
.00
13 Donation to the Korea/Vietnam Memorial, Inc., a National Education Center. . . . . . . . . . . . . . . . . . . . . . . 13
$
.00
14 Donation to Breast and Cervical Cancer Research. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
$
.00
$
15 Refund check mailed directly to you. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
.00
THE TOTAL OF LINES 10 THROUGH 15 MUST EQUAL LINE 9
PART 6
SIGNATURE(S) AND TELEFILE CONFIRMATION INFORMATION.
After you, (and your spouse, if filing jointly) listen to the taxpayer’s oath, you (both) must
sign your TeleFile Return by entering your Personal Identification Number(s) when prompted by the TeleFile system. This (These) is (are) your lawful signature(s) that the PA
Department of Revenue will retain for future verification.
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Your TeleFile Confirmation Number
Date:
DO NOT MAIL
If you have a question about your TeleFile return, you will need this Confirmation Number.
this TeleFile Worksheet.
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