Form Pa-41a - Pa-41 Schedule A - Interest Income And Gambling And Lottery Winnings - 2012
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11204310054
PA-41 SCHEDULE A
Interest Income and Gambling
and Lottery Winnings
2012
OFFICIAL USE ONLY
PA-41A (06–12) (FI)
START
Name as shown on the PA-41
Federal EIN or Decedent’s SSN
Caution: Federal and Pennsylvania rules for taxable interest income are different. You cannot use the federal schedule to report Pennsylvania interest
income. Read the instructions. If the taxable interest income is $2,500 or less, the fiduciary must report the income, but is not required to submit PA-41
Schedule A. If the interest income is more than $2,500, the fiduciary must submit PA-41 Schedule A. List the name of each payer and the amount of
Pennsylvania-taxable interest income you received during the year.
1. $
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2. $
2. Total interest income. Add all amounts listed.
3. $
3. Interest income from partnership(s), from PA Schedule(s) RK-1
4. $
4. Interest income from PA S corporation(s), from PA Schedule(s) RK-1
5. $
5. Gambling and lottery winnings. See instructions.
6. Total interest income and gambling and lottery winnings
$
Add Lines 2, 3, 4, and 5. Enter on Line 1 of the PA-41.
6.
Reset Entire Form
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1204310054
1204310054
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Parent category: Financial