Form Wt-1 - Employer Quarterly Withholding & Reconciliation

WT-1 2001

EMPLOYER QUARTERLY

WITHHOLDING & RECONCILIATION

City of Pittsburgh

School District of Pittsburgh

and

Rev 10/00

FOR OFFICIAL USE ONLY

Tax return is not needed because I no longer employ City or School District of

CITY ID

FEDERAL ID

Pittsburgh residents, as of _________/_________/_________.

__________________________________________________

TAX PERIOD

QUARTER

SIGNATURE

Due on or before

_________________________________________________

Title

_________________________________________________

Phone

Date

I hereby certify, swear and aver that all statements herein are true and correct to

the best of my knowledge and belief, being duly appraised of my duty under the law

to submit honest and complete information or be subject to the penalties provided

by law.

COLUMN A

COLUMN B

COLUMN C

CITY TAX 1%

SCHOOL TAX 2%

NON-RESIDENT OF PA OR U.S. 1%

QUARTERLY TAXABLE WAGES

. ADJUSTMENT OF WAGES

Include a detailed explanation

3. TAXABLE WAGES THIS QUARTER

Subtract line 2 from line 1

4. TAX DUE ON WAGES

Multiply line 3 by rate for column

LINES 5, 6 AND 7 ARE FOR MONTHLY FILERS ONLY. Employers who do not file monthly (form WTD) go to line 8.

5. TAX WITHHELD and DEPOSITED

for 1

MONTH of this QUARTER

6. TAX WITHHELD and DEPOSITED

for 2

MONTH of this QUARTER

7. TOTAL - FIRST TWO MONTHLY

DEPOSITS Add line 5 and line 6

8. BALANCE DUE WITH THIS

RETURN Subtract line 7 from line 4

TOTAL 6% - If Applicable

TOTAL 5.5% - If Applicable

TOTAL 6% - If Applicable

9. PENALTY and INTEREST

City Penalty 5% (0.05) – City Interest 1% (0.01)

School Penalty 5%(0.05) – School Interest 0.5% (0.005)

City Penalty 5% (0.05) – City Interest 1% (0.01)

Penalty and Interest per month

If Applicable

10. SUBTOTAL

Add line 8 and line 9

11. TOTAL REMITTANCE WITH THIS RETURN Add the amounts on line 10, columns A, B & C

Make check payable to: TREASURER, CITY OF PITTSBURGH – DO NOT SEND CASH

Mail to: CITY OF PITTSBURGH WAGE TAX – PO BOX 642595 – PITTSBURGH PA 15264-2595

A $20.00 fee will be assessed for any check returned from the bank for any reason.

Has business been sold or discontinued? If YES, a BUSINESS DISCONTINUATION FORM must be completed and returned for processing.

Form(s) can be downloaded at or call 412-255-2510 to request the form.

MAKE CORRECTIONS BELOW

__________________________________________________________

PAYMENT DUE – PO BOX 642595 – PITTSBURGH PA 15264-2595

NAME

FEDERAL ID

NO TAX DUE – PO BOX 642664 – PITTSBURGH PA 15264-2664

REFUND – PO BOX 642650 – PITTSBURGH PA 15264-2650

___________________________________________________________

TAX DUE, NO PAYMENT – PO BOX 642617 – PITTSBURGH PA 15264-2617

ADDRESS

Form Wt-1 - Employer Quarterly Withholding & Reconciliation - 2001

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