Form Rev-414(I) Ex - Individuals Worksheet

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REV-414(I) EX (07-11)
INDIVIDUALS WORKSHEET
PA DEPARTMENT OF REVENUE
(Keep for your records.)
PART A. 2012 PA ESTIMATED TAX WORKSHEET
1. Enter the amount of Pennsylvania taxable income you expect in 2012. Do not
include your compensation from which your employer will withhold PA income tax. . . . . . . . . . . . . . . 1.
2. Tax. Multiply the amount on Line 1 by 3.07% (0.0307). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.
3. Estimated 2012 credit for income tax to be paid to other states. . . . . . . . . . . . . . . . . . . . . . 3.
4. Estimated 2012 PA Employment Incentive Payment Tax Credit. . . . . . . . . . . . . . . . . . . . . . 4.
5. Estimated 2012 PA Job Creation Tax Credit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.
6. Estimated 2012 PA Research and Development Tax Credit. . . . . . . . . . . . . . . . . . . . . . . . . 6.
7. Estimated 2012 PA Film Production Tax Credit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.
8. Estimated 2012 PA Organ and Bone Marrow Donor Tax Credit. . . . . . . . . . . . . . . . . . . . . . 8.
9. Estimated 2012 PA Keystone Innovation Zone Tax Credit. . . . . . . . . . . . . . . . . . . . . . . . . . 9.
10. Estimated 2012 PA Resource Enhancement and Protection Tax Credit. . . . . . . . . . . . . . . . 10.
11. Estimated 2012 PA Neighborhood Assistance Program Tax Credit. . . . . . . . . . . . . . . . . . . 11.
12. Estimated 2012 PA Strategic Development Area Job Creation Tax Credit. . . . . . . . . . . . . . 12.
13. Estimated 2012 PA Educational Improvement Tax Credit. . . . . . . . . . . . . . . . . . . . . . . . . . . 13.
14. Estimated 2012 PA Volunteer Responder Retention and Recruitment Tax Credit. . . . . . . . 14.
15. Estimated 2012 PA Keystone Special Development Zone Tax Credit. . . . . . . . . . . . . . . . . . 15.
16. Other 2012 PA Schedule OC Credit not listed above. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.
17. Estimated 2012 Special Tax Forgiveness Credit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.
18. Add Lines 3 through 17. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.
19. TOTAL 2012 ESTIMATED TAX. Subtract Line 18 from Line 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
20. Enter 90% of Line 19. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.
21. Enter 100% of your PA taxable income for 2011. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.
NOTE: If a part-year resident for 2011 or no return filed for 2011, skip Lines 21 through 25 and enter the amount from Line 20 on Line 26.
22. Figure your tax by multiplying Line 21 by 3.07% (0.0307). . . . . . . . . . . . . . . . . . . . . . . . . . 22.
23. Enter the amount of your expected 2012 withholdings including excess (over 3.07%)
PA income tax you asked your employer to withhold. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.
24. Add Lines 18 and 23. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.
25. If Line 24 is less than Line 22, subtract Line 24 from Line 22 and enter the amount here.
If Line 24 is more than Line 22, enter a 0 (zero). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.
26. Enter the smaller of Line 20 or 25. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.
27. If you are a non-PA resident, include income tax to be withheld
by your PA S corporation or partnership. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27.
28. Subtract Line 27 from Line 26. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.
29. TOTAL REQUIRED ANNUAL ESTIMATED TAX. If Line 28 is $246 or more, enter it here.
This is the amount of total estimated tax payments you are required to make for 2012.
If Line 28 is less than $246, you are not required to make estimated payments. . . . . . . . . . . . . . . . . 29.
NOTE: The department will apply your credit from your 2011 PA PIT return on the due date of your 2011 PA return. If your 2011 credit
is greater than your first 2012 installment payment, it is not necessary that you file your first estimated form. The department does not
require a 2012 PA PIT estimated form until you must make a payment to your estimated account.
PART B. 2012 AMENDED PA ESTIMATED TAX SCHEDULE
1. Amended estimated tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.
2. Amount of 2011 overpayment applied to 2012 estimated tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.
3. Estimated tax payments you made to date. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.
4. Total (add Lines 2 and 3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.
5. Unpaid balance (subtract Line 4 from Line 1). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.
PART C. 2012 RECORD OF ESTIMATED TAX PAYMENTS
Payment
(c) 2011 overpayment
(d) Total amount paid and
(a) Date
(b) Amount
number
credit applied
credited [add (b) and (c)]
1
2
3
4
Total

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