Form I301 - Local Earned Income Tax Return - Berkheimer Tax Administrator Page 5
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5I306
9/07
LOCAL EARNED INCOME TAX RETURN
610-599-3139
YOUR COPY
KEEP for Your Records
Tax Rate __________ Tax Year __________
Tax Jurisdiction ________________________
Your S. S. #
Spouse's S. S. #
* SEE INSTRUCTION SHEET FOR DETAILS *
1.
.........
1
Gross Earnings as reported on W-2. Enclose W-2(s) with your return (photocopies of W-2s are accepted)
2.
Allowable Non-reimbursed Employee Business expenses. (See Instructions Line 2)
............................................. 2
3. Taxable W-2 earnings (1 minus 2)
.... 3
Audit may be required if all W-2s & supporting schedules are not enclosed
4. Net Loss (Use line 6 for any Net profits)
(See Instructions Line 4) ............................................................ 4
5. Subtotal (Line 3 minus line 4) IF LESS THAN ZERO, ENTER ZERO .................................................... 5
6. Net Profits (Use line 4 for any Net losses)
(See Instructions Line 6) ...........................................
.......... 6
7. Total Earned Income subject to this tax (Line 5 plus line 6) .......................................................................... 7
8. Tax Liability - Line 7 multiplied by Tax rate printed on tax return................................................................ 8
9. Quarterly Estimated Payments .......................................................................................................................... 9
10. Earned Income Tax Withheld as per W-2 (See instructions line 10) .............................................................. 10
11. Credit from last year (If Credit Due)................................................................................................................ 11
12. Miscellaneous credits (i.e. Philadelphia Tax or Out-of-State Tax Credit - see reverse) .................................. 12
13. Total of 9 + 10 + 11 + 12 ................................................................................................................................ 13
14. REFUND / CREDIT: (Line 13 minus line 8) IF $1.00 OR MORE, enter amount and check one box below:
14
Credit to Spouse
Credit to next year
Refund
NO REFUNDS OR CREDITS UNDER $1.00
15. TAX DUE: (Line 8 minus line 13) OMIT IF LESS THAN $1.00 ................................................................ 15
16. Interest & Penalties... LEAVE BLANK IF PAID WHEN DUE .......................................................................... 16
17. TOTAL AMOUNT DUE (lines 15 + 16) ...................................................................................................... 17
You are entitled to receive a written explanation of your rights with regard to the audit, appeal, enforcement, refund and
collection of local taxes by calling Berkheimer at 610-599-3139, during the hours of 9:00 a.m. through 4:30 p.m., Monday
through Friday. Or, you can visit our website at or contact us by e-mail at . If
Berkheimer is not the appointed tax hearing officer for your taxing district, you must contact your
taxing district about the proper procedures and forms necessary to file an appeal.
* QUESTIONS AND ANSWERS ON REVERSE SIDE *
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