Form 531-Wh - Local Earned Income Tax Return - 2009
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1TAX OFFICE USE ONLY - DO NOT WRITE IN THIS AREA
RETURN BY APRIL 15, 2010 TO:
2009
CAPITAL TAX COLLECTION BUREAU
LOCAL EARNED INCOME TAX
RETURN (FORM 531-WH)
TO CONSTITUTE PROOF OF FILING, THE TAXPAYER'S COPY MUST BE
PAXTANG BOROUGH, PENBROOK BOROUGH
VALIDATED BY THE BUREAU. TO HAVE YOUR COPY VALIDATED BY MAIL,
Click Here to Clear Form Data
WEST HANOVER TOWNSHIP
RETURN BOTH THE BUREAU'S AND TAXPAYER'S COPIES ALONG WITH A SELF
ADDRESSED STAMPED ENVELOPE.
SOC. SEC. NO. A
SOC. SEC. NO. B
A HUSBAND AND WIFE MAY BOTH FILE ON THIS FORM. HOWEVER, TAX CALCULATIONS MUST BE REPORTED IN SEPARATE
COLUMNS. JOINT FILING (I.E., COMBINING INCOME, ETC.) IS NOT PERMITTED.
W-2 EARNINGS (From attached W-2s)
1
1
EMPLOYEE BUSINESS EXPENSES (EBEs) (Attached Federal Form 2106 & State Schedule UE)
2
2
3
TAXABLE W-2 EARNINGS LESS EBEs (Subtract Line 2 from Line 1)
3
0.00
0.00
4
OTHER TAXABLE EARNED INCOME (NO INTEREST OR DIVIDENDS) LIST TYPE: __________________
4
TOTAL TAXABLE EARNED INCOME (Add Lines 3 and 4)
5
5
0.00
0.00
NET PROFIT FROM BUSINESS, PROFESSION OR FARM (Attach Federal and State Schedules C, F and/or K1 (1065))
6
6
7
7
NET LOSS(ES) FROM BUSINESS, PROFESSION OR FARM (Attach Federal and State Schedules C, F and/or K-1 (1065))
8
Subtract Line 7 from Line 6 (IF LESS THAN ZERO, ENTER ZERO)
0.00
0.00
8
REQUIRED FOR INFORMATION PURPOSES ONLY: Enter Net, Subchapter S Corporation pass-thru Net Profit(s)/Loss(es) as reported on
9
9
your PA-40 return
TOTAL TAXABLE EARNED INCOME AND NET PROFITS (Add Lines 5 and 8)
10
0.00
0.00
10
11
TAX RATE FOR PAXTANG BOROUGH, PENBROOK BOROUGH OR WEST HANOVER TOWNSHIP
0.005
0.005
11
0.005
0.005
12
TAX LIABILITY: Multiply Line 10 by Line 11
0.00
0.00
12
TOTAL LOCAL INCOME TAXES WITHHELD EXCEPT PHILADELPHIA INCOME TAX
(Complete Chart A on the reverse side of the "Bureau's
13
13
Copy" of the return to determine the correct entry/entries for this line. Also attach a copy of the W-2 form provided by each of your employers.)
QUARTERLY PAYMENTS AND/OR LAST YEAR’S OVERPAYMENT CREDITED TO THIS YEAR
14
14
CREDITS FOR TAXES PAID TO PHILADELPHIA AND/OR STATES OTHER THAN PA (ATTACH SCH. G) AND/OR CREDITS FOR
15
15
CERTIFIED RESIDENTS OF THE HARRISBURG KEYSTONE OPPORTUNITY ZONE (KOZ)
TOTAL WITHHOLDINGS & PAYMENTS (Add Lines 13, 14 and 15)
0.00
16
0.00
16
17
TAX BALANCE DUE (Subtract Line 16 from Line 12) PAYMENT NOT NECESSARY IF LESS THAN $1.00
0.00
17
0.00
INTEREST & PENALTY (See Instructions)
18
18
TOTAL BALANCE DUE (Add Lines 17 and 18) Make check payable to "CTCB"
Place Social security Number on Check
19
0.00
0.00
19
20
OVERPAYMENT (Subtract Line 12 from Line 16) IF LESS THAN ZERO, ENTER ZERO
20
0.00
0.00
OVERPAYMENT TO BE REFUNDED
21
21
0.00
0.00
Taxpayer 'A', 'B', or 'BOTH' Savings or Checking Acct.
ROUTING NO.
ACCOUNT NO.
DIRECT
DEPOSIT
Select
Select
INFORMATION
Select
Select
OVERPAYMENT TO BE CREDITED TO NEXT YEAR'S TAX
22
22
23
OVERPAYMENT TO BE CREDITED TO SPOUSE'S BALANCE DUE FOR THIS FILING YEAR
23
TYPE OR PRINT INFORMATION BELOW. IF PREPRINTED, CHECK FOR ACCURACY AND MAKE CORRECTIONS WHERE NECESSARY.
SPOUSE’S NAME, SIGNATURE, AND OTHER INFORMATION SHOULD BE PROVIDED ONLY IF HE OR SHE IS ALSO FILING ON THIS FORM.
YOUR PIN NUMBER FOR
YOUR NAME
A
YOUR CTCB ACCOUNT NUMBER (IF KNOWN)
Your Social Security Number
ONLINE FILING
(LAST, FIRST, M)
Enter at right >>>>>>>>>
SPOUSE'S PIN NUMBER FOR
SPOUSE'S NAME
B
Spouse Social Security Number
SPOUSE'S CTCB ACCOUNT NUMBER (IF KNOWN)
ONLINE FILING
(LAST, FIRST, M)
Enter at right >>>>>>>>>
IF YES, COMPLETE SCHEDULE P AND A
HAVE YOU MOVED FROM THE
YES
HOME
SEPARATE RETURN FOR EACH CTCB
BEGINNING OF THE TAX FILING
MUNICIPALITY WHERE YOU RESIDED
ADDRESS Enter at right >>
NO
YEAR TO PRESENT?
DURING THE TAX YEAR
DAYTIME PHONE NUMBER
YOUR RESIDENT MUNICIPALITY
(TOWNSHIP, BOROUGH OR CITY)
SELECT YOUR MUNICIPALITY
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE EXAMINED THIS RETURN AND ACCOMPANYING SCHEDULES AND STATEMENTS,
AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, THEY ARE TRUE, CORRECT AND COMPLETE.
YOUR SIGNATURE
DATE
YOUR OCCUPATION
X
X
X
X
12/31/2009
SPOUSE'S SIGNATURE (ONLY IF ALSO FILING ON THIS FORM)
DATE
SPOUSE'S OCCUPATION (ONLY IF ALSO FILING ON THIS FORM)
X
X
X
X
12/31/2009
PAID PREPARER’S NAME (PLEASE PRINT)
FIRM’S NAME (OR ENTER “S.E.” IF SELF EMPLOYED)
PAID PREPARER’S PHONE NUMBER
BUREAU'S COPY
Bureau's Copy
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