Annual Reconciliation Of Employer Wage Tax - City Of Philadelphia - 2010
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1City Account Number
CITY OF PHILADELPHIA
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ANNUAL RECONCILIATION OF
2010 EMPLOYER WAGE TAX
DUE DATE: FEBRUARY 28, 2011
Federal Identification Number
Name and Address
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To file online, click on "Online Services" at
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m m
d d
y y y y
If your business terminated in 2010, enter the termination date AND file a CHANGE FORM.
YOU MUST USE THE CHANGE FORM TO REPORT A CHANGE OF ADDRESS.
If this is an amended return place an "X" here:
A. Enter the number of Philadelphia Residents for whom wage tax was remitted for the pay period including
March 12, 2010.....................................................................................................................................................A.
B. Enter the number of nonresidents (employees living outside Philadelphia city limits) for whom wage tax
was remitted for the pay period including March 12, 2010...................................................................................B.
C. Total number of employees for all company locations reported on the Employer's Federal Quarterly
Tax Return for the first quarter of 2010 (for the pay period including March 12, 2010)........................................C.
D. Number of employees working at company locations within Philadelphia city limits, for the pay period
including March 12, 2010......................................................................................................................................D.
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1. Gross Compensation per W-2 forms for all employees...................................................1.
2. Non-Taxable Gross Compensation included in Line 1.
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,
. 0 0
(Paid to nonresidents working outside of Philadelphia)...................................................2.
3. Gross Compensation per W-2 forms on which Philadelphia Wage Tax was
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. 0 0
withheld or due (Line 1 minus Line 2)..............................................................................3.
4. Taxable Gross Compensation paid to residents of Philadelphia
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. 0 0
January 1, 2010 to June 30, 2010..................................................................................4.
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. 0 0
5. Tax Due (Line 4 times .039296).......................................................................................5.
6. Taxable Gross Compensation paid to residents of Philadelphia
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. 0 0
July 1, 2010 to December 31, 2010...............................................................................6.
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. 0 0
7. Tax Due (Line 6 times .039280).......................................................................................7.
8. Taxable Gross Compensation paid to nonresidents of Philadelphia
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. 0 0
January 1, 2010 to June 30, 2010..................................................................................8.
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. 0 0
9. Tax Due (Line 8 times .034997).......................................................................................9.
10. Taxable Gross Compensation paid to nonresidents of Philadelphia
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. 0 0
July 1, 2010 to December 31, 2010..............................................................................10.
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. 0 0
11. Tax Due (Line 10 times .034985)...................................................................................11.
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. 0 0
12. Total Tax Due (Add Lines 5, 7, 9 and 11).....................................................................12.
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. 0 0
13. Tax previously paid for 2010.......................................................................................13.
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. 0 0
14. ADDITIONAL TAX DUE If Line 12 is greater than Line 13, enter the amount here.................14.
15. TAX OVERPAID If Line 13 is greater than Line 12, enter the amount here.
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. 0 0
See instructions for filing a Refund Petition...............................................................................15.
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 #_________________________
Preparer Signature_________________________________________ Date_______________________Phone #_________________________
5010 Internet 9-17-2010 Final
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