Form Pgh-40 - Individual Earned Income - City And School District Of Pittsburgh - 2007 Page 2
ADVERTISEMENT
1
2Form WTEX - NON-RESIDENT EXEMPTION CERTIFICATE
CLAIM FOR EXEMPTION FROM CITY OF PITTSBURGH AND/OR SCHOOL DISTRICT EARNED INCOME TAX
FOR FULL-YEAR PENNSYLVANIA RESIDENTS ONLY
COMPLETE THIS FORM IF YOUR RESIDENCY STATUS IS ONE OF THE FOLLOWING:
2 - Full-Year Mt. Oliver Resident
4 - Part Year Resident of Pittsburgh
5 - Non-Resident of Pittsburgh
residing within the State of PA
residing within the State of PA
during all of 2007.
during all of 2007.
If you lived in another state during any part of the year, do not complete this Form WTEX, but include copies of your PA and out of state returns.
Taxpayer Name___________________________________Social Security No.___________________Daytime Phone________________
Current
Address__________________________________________City______________________State_________Zip_________________
I was a resident of (Boro or Township)_______________________________________________________for all or part of year 2007.
I lived in the above municipality from ___________/____________/_____________ to __________/______________/_______________
As a resident of this municipality I earned $_______________________and I owe/paid $_______________________in earned income tax.
Therefore I was not liable for City of Pittsburgh and/or School District of Pittsburgh Earned Income Tax.
MUST BE VERIFIED AND SIGNED BY YOUR LOCAL TAX COLLECTOR FROM A PENNSYLVANIA MUNICIPALITY
I certify that the person above was registered as a taxpayer in my jurisdiction for the tax year 2007 and owes or has paid the
Earned Income Tax to his/her place of residence in the amount stated above.
____________________________________________________________
SEAL
Tax Collector’s Signature
Date
Phone
A completed PGH-40 must accompany all WTEX Forms.
The balance of tax due on Form PGH-40 must be paid in full by the filing date by check. DO NOT SEND CASH. Make check payable to
“TREASURER, CITY OF PITTSBURGH” and mail it with your return. Please write your Account No. (found in the upper left corner of the
Taxpayer Information Box on Form PGH-40) or Social Security No. on your check .
DO NOT STAPLE ANY PAPERS TO THE RETURN.
IF ALL APPLICABLE INFORMATION IS NOT PROVIDED, YOUR PGH-40 WILL BE RETURNED.
Please mail your completed PGH-40 Income Tax Return in the envelope provided using
the correct color-coded label to the address indicated below.
R
E
F
U
N
D
R
E
Q
U
E
S
T
E
D
C
R
E
D
I
T
R
E
Q
U
E
S
T
E
D
N
O
T
A
X
D
U
E
–
N
O
R
E
F
U
N
D
R E
E F
F U
U N
N D
D R
R E
E Q
Q U
U E
E S
S T
T E
E D
D
C R
R E
E D
D I
I T
T R
R E
E Q
Q U
U E
E S
S T
T E
E D
D
N
O
T
A
X
D
U
E
–
N
O
R
E
F
U
N
D
R
C
N
O
T
A
X
D
U
E
–
N
O
R
E
F
U
N
D
TREASURER – CITY OF PITTSBURGH
TREASURER – CITY OF PITTSBURGH
TREASURER – CITY OF PITTSBURGH
414 GRANT ST
414 GRANT ST
P.O.BOX 2701
PITTSBURGH PA 15219-2476
PITTSBURGH PA 15219-2476
PITTSBURGH PA 15230-2701
T
A
X
D
U
E
-
P
a
r
t
i
a
l
O
R
N
o
P
a
y
m
e
n
t
T A
A X
X D
D U
U E
E -
- P
P a
a r
r t
t i
i a
a l
l O
O R
R N
N o
o P
P a
a y
y m
m e
e n
n t
t
T
T
A
X
D
U
E
-
F
u
l
l
P
a
y
m
e
n
t
E
n
c
l
o
s
e
d
T A
A X
X D
D U
U E
E -
- F
F u
u l
l l
l P
P a
a y
y m
m e
e n
n t
t E
E n
n c
c l
l o
o s
s e
e d
d
T
E
n
c
l
o
s
e
d
E n
n c
c l
l o
o s
s e
e d
d
E
Returns sent to the incorrect address will
TREASURER – CITY OF PITTSBURGH
TREASURER – CITY OF PITTSBURGH
be delayed
414 GRANT ST
P.O. BOX 642583
PITTSBURGH PA 15219-2476
PITTSBURGH PA 15264-2583
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Pgh-40 - Individual Earned Income/form Wtex - Non-resident Exemption Certificate - 2005
Financial
Form Pgh-40 - Individual Earned Income/form Wtex - Non-resident Exemption Certificate - 2006
Financial
Form Pgh-40 - Individual Earned Income/form Wtex - Non-resident Exemption Certificate - 2001
Financial
Form Pgh-40 - Individual Earned Income/form Wtex - Non-resident Exemption Certificate - 2002
Financial
Form Pgh-40 - Individual Earned Income/form Wtex - Non-resident Exemption Certificate - 2003
Financial
Form Pgh-40 - Individual Earned Income/form Wtex - Non-resident Exemption Certificate - 2000
Financial
Related Categories
Parent category: Financial