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Employers and taxpayers use it to report the information required to collect and distribute local earned income taxes to the local EIT collector, including rules for new hires and address or name changes. The form collects employee residence details (including PSD code and resident EIT rate) and employer employment-location information (including work PSD code and non-resident EIT rate). It also includes an employee perjury certification with signature date, phone, and email, and directs users to Pennsylvania DCED Act 32 resources for municipality details, PSD codes, and EIT rates.",{"@graph":63,"@context":110},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/clgs-32-6-residency-certification-form-local-earned-income-tax-withholding/304952/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/clgs-32-6-residency-certification-form-local-earned-income-tax-withholding/304952.png","ImageObject",442,249,{"name":88,"@type":89},"Mason","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-26","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":73},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104],{"name":105,"@type":106,"acceptedAnswer":107},"How is the certification completed and where can tax rates be found?","Question",{"text":108,"@type":109},"The employee signs under penalties of perjury and provides a date (MM/DD/YYYY), phone number, and email address. Municipality details, PSD codes, and EIT rates are referenced through the Pennsylvania DCED Act 32 website.","Answer","https://schema.org",{"og:url":78,"og:type":112,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":114,"canonical":78},"index,follow",{"doc_id":116,"site_id":56},304952,1790385447,{"code":4,"msg":5,"data":119},{"doc_id":116,"user_id":120,"nickname":88,"user_avatar":121,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":122,"file_id":123,"file_url":124,"file_type":125,"file_size":126,"view_count":47,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":127,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":128,"faqs":129,"seo_title":130,"seo_description":61,"update_tm":131,"read_time":4},5909887256941,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","CLGS-32-6 (05/17)  \nRESIDENCY CERTIFICATION FORM Local Earned Income Tax Withholding  \nTO EMPLOYERS/TAXPAYERS:  \nThis form is to be used by employers and taxpayers to report essential information for the collection and distribution of Local Earned Income Taxes to the local EIT collector. This form must be used by employers when a new employee is hired or when a current employee notifies employer of a name or address change. Use the Address Search Application [at dced.pa.gov/Act32 to determine PSD codes](at dced.pa.gov/Act32 to determine PSD codes), EIT rates,  \nand tax collector contact information.  \nEMPLOYEE INFORMATION – RESIDENCE LOCATION  \n\n| NAME (Last Name, First Name, Middle Initial) |  |  | SOCIAL SECURITY NUMBER\u003Cbr> |\n| --- | --- | --- | --- |\n| STREET ADDRESS (No PO Box, RD or RR) |  |  |  |\n| ADDRESS LINE 2 |  |  |  |\n| CITY | STATE | ZIP CODE | DAYTIME PHONE NUMBER |\n| MUNICIPALITY (City, Borough or Township) |  |  |  |\n| COUNTY | RESIDENT PSD CODE\u003Cbr> |  | TOTAL RESIDENT EIT RATE |\n\nEMPLOYER INFORMATION – EMPLOYMENT LOCATION  \n\n| EMPLOYER BUSINESS NAME (Use Federal ID Name) |  |  |  | EMPLOYER FEIN \u003Cbr>|\n| --- | --- | --- | --- | --- |\n| STREET ADDRESS WHERE ABOVE EMPLOYEE REPORTS TO WORK (No PO Box, RD or RR) |  |  |  |  |\n| ADDRESS LINE 2 |  |  |  |  |\n| CITY | STATE | ZIP CODE |  | PHONE NUMBER |\n| MUNICIPALITY (City, Borough or Township) |  |  |  |  |\n| COUNTY | WORK LOCATION PSD CODE\u003Cbr> |  | WORK LOCATION NON-RESIDENT EIT RATE |  |\n\nCERTIFICATION  \n\n| 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. |  |  |\n| --- | --- | --- |\n|  |  |  |\n| SIGNATURE OF EMPLOYEE |  | DATE (MM/DD/YYYY) |\n| PHONE NUMBER | EMAIL ADDRESS |  |\n\nFor information on obtaining the appropriate MUNICIPALITY (City, Borough, Township), PSD CODES, and EIT (Earned Income Tax) RATES, please refer to the Pennsylvania Department of Community & Economic Development website:  \n[dced.pa.gov/Act32](dced.pa.gov/Act32)","cbCaikvjVggNdYdq","https://ap.wps.com/l/cbCaikvjVggNdYdq","pdf",201598,"English","# Employee Information – Residence Location\n# Employer Information – Employment Location\n# Certification","[{\"question\":\"How is the certification completed and where can tax rates be found?\",\"answer\":\"The employee signs under penalties of perjury and provides a date (MM/DD/YYYY), phone number, and email address. Municipality details, PSD codes, and EIT rates are referenced through the Pennsylvania DCED Act 32 website.\"}]","CLGS-32-6 - Residency Certification Form - Local Earned Income Tax Withholding | PDF",1789820189]