Annual Reconciliation Of 2010 Employee Earnings Tax - City Of Philadelphia
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1SOCIAL SECURITY NUMBER
CITY OF PHILADELPHIA
6
0
1
0
ANNUAL RECONCILIATION OF 2010
EMPLOYEE EARNINGS TAX
DUE DATE APRIL 15, 2011
Do not file this return if Philadelphia wage tax was
withheld on all compensation (Line 12 = Line 13).
Name and Address
File a Change Form to cancel this account.
If wage tax was overwithheld by your employer, do
not file this return. File the Employee Wage Tax
Refund Petition.
Download forms at
-
-
m m
d d
y y y y
To cancel this account enter the termination date AND file a CHANGE FORM.
If this is an amended return place an "X" here:
YOU MUST USE THE CHANGE FORM TO REPORT A CHANGE OF ADDRESS.
,
,
.00
1. Gross Compensation received in 2010. Enclose 2010 W-2 form(s)........................1.
,
,
.00
2. Non-taxable gross compensation from Page 2, Line 5.............................................2.
.00
,
,
3. Gross taxable compensation (Line 1 minus Line 2)..................................................3.
4. Taxable Gross Compensation received by a resident of Philadelphia
.00
,
,
January 1, 2010 to June 30, 2010...........................................................................4.
,
,
.00
5. Tax Due (Line 4 times .039296)................................................................................5.
6. Taxable Gross Compensation received by a resident of Philadelphia
,
,
.00
July 1, 2010 to December 31, 2010 ........................................................................6.
.00
,
,
7. Tax Due (Line 6 times .039280)................................................................................7.
8. Taxable Gross Compensation received by a nonresident of Philadelphia
.00
,
,
January 1, 2010 to June 30, 2010...........................................................................8.
.00
,
,
9. Tax Due (Line 8 times .034997)................................................................................9.
10. Taxable Gross Compensation received by a nonresident of Philadelphia
,
,
.00
July 1, 2010 to December 31, 2010.......................................................................10.
,
,
.00
11. Tax Due (Line 10 times .034985)............................................................................11.
.00
,
,
12. Total Tax Due (Add Lines 5, 7, 9 and 11)...............................................................12.
.00
,
,
13. Any Philadelphia wage tax withheld by employer per enclosed W-2 forms............13.
If Line 12 is equal to Line 13, STOP HERE! Do not file this return.
,
,
.00
14. Net Tax Due (Line 12 minus Line 13).....................................................................14.
15. Tax that you, not your employer, previously paid for 2010.
,
,
.00
(Not included on W-2 forms).................................................................................. 15.
16. ADDITIONAL TAX DUE If Line 14 is greater than Line 15, enter here
.00
,
,
and in the Tax Due box of the Payment Coupon below..........................................16.
OVERPAYMENT OPTIONS If Line 14 is less than Line 15, enter the amount to be:
.00
,
,
17A. REFUNDED. Do not file a separate Refund Petition.......................................17A.
OR
.00
,
,
17B. APPLIED, up to the tax due, to the 2011 Earnings Tax Return............................17B.
If claiming a refund on line 17A, W-2 forms must accompany this return. Do not file a separate Refund Petition.
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 #_________________________
Page 1
6010 Internet 9-20-2010 Final
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