Taxpayer Annual Local Earned Income Tax Return - York Adams Tax Bureau
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1YATB-TO-32
TAXPAYER ANNUAL LOCAL EARNED INCOME TAX RETURN
YATB-TO-32
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 contacting your Tax Officer.
York - 717.845.1584
Adams - 717.334.4000
Information and Efile at www yatb com
2014
EXTENSION
AMENDED RETURN
TAX YEAR
to
DATES LIVING AT EACH ADDRESS
STREET ADDRESS (NO PO BOX, RD OR RR)
CITY OR POST OFFICE
STATE
ZIP
to
to
*SEE INSTRUCTIONS
RESIDENT PSD CODE
DAYTIME PHONE NUMBER
TAXPAYER’S SOCIAL SECURITY #
SPOUSE’S SOCIAL SECURITY #
ONLY USE BLACK OR BLUE INK TO COMPLETE THIS FORM
If you had NO EARNED INCOME,
If you had NO EARNED INCOME,
fill in the box as to the reason why:
fill in the box as to the reason why:
The amounts reported must correspond to the individuals social security number printed in
each column. Combining income is NOT permitted.
Disabled
Deceased
Retired
Disabled
Deceased
Retired
TAXPAYER’S EMAIL ADDRESS
Date above occured:
Date above occured:
M
M
D D
Y
Y Y Y
M
M
D D
Y
Y Y Y
DO NOT USE BOX 1 FOR WAGES
......................
0 0
0 0
1. Gross Compensation as Reported on W-2(s). (Enclose W-2’s)
,
,
.
,
,
.
.........
0 0
0 0
2. Unreimbursed Employee Business Expenses. (Enclose PA Schedule UE)
,
,
.
,
,
.
................................................................
0 0
0 0
3. Other Taxable Earned Income*
,
,
,
.
,
.
.........
0 0
0 0
4. Total Taxable Earned Income(Subtract Line 2 from Line 1 and add Line 3)
,
,
.
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.
0 0
0 0
5. Net Profit (Enclose PA Schedules*)
NON-TAXABLE S-Corp earnings enter below
,
,
.
,
,
.
00
00
Taxpayer A $
Taxpayer B $
..........................................................
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0 0
0 0
6. Net Loss (Enclose PA Schedules*)
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.
....
0 0
0 0
7. Total Taxable Net Profit (Subtract Line 6 from Line 5. If less than zero, enter zero)
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..................
0 0
0 0
8. Total Taxable Earned Income and Net Profit (Add Lines 4 and 7)
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...................
0 0
0 0
9. Total Tax Liability (Line 8 multiplied by rate from local EIT tax chart)
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.......................
0 0
0 0
10. Total Local Earned Income Tax Withheld as Reported on W-2(s)
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.
........................
0 0
0 0
11. Quarterly Estimated Payments/Credits From Previous Tax Year
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,
.
....................................
0 0
0 0
12. Miscellaneous Tax Credits (Enclose documentation)*
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,
.
........................
0 0
0 0
13. TOTAL PAYMENTS AND CREDITS (Add lines 10 through 12)
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.
..................
0 0
0 0
14. REFUND If $2.00 or more, enter amount
(Or select option in 15)
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0 0
0 0
15. Credit Taxpayer/Spouse (Amount of line 14 you want to transfer) ..............................
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Credit to next year
Credit to spouse
0 0
0 0
16. EARNED INCOME TAX BALANCE DUE (Line 9 minus line 13)..........................
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.
If $2.00 or more, enter amount
MAKE CHECK PAYABLE TO YATB
17. Penalty after April 15* (Multiply line 16 by % rate per instructions)........................
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18. Interest after April 15* (Multiply line 16 by % rate per instructions)........................
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19. TOTAL PAYMENT DUE (Add lines 16, 17 and 18).....................................................
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Under penalties of perjury, I (we) declare that I (we) have examined this information, including all accompanying schedules and statements and to the best of my (our) belief, they are true, correct and complete.
YOUR SIGNATURE/OCCUPATION
SPOUSE’S SIGNATURE/OCCUPATION
DATE (MM/DD/YYYY)
PREPARER’S PRINTED NAME AND SIGNATURE
EMAIL
PHONE NUMBER
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