[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-304421-105":53,"doc-detail-304421-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","earned-income-tax-questionnaire-for-berkheimer","Earned Income Tax Questionnaire - For Berkheimer","","Earned income tax questionnaire letter and form text for Berkheimer, explaining requirements under Pennsylvania Act 511 and related local tax resolutions. Residents are instructed to detach and return the completed questionnaire within ten days to fulfill registration obligations and enable accurate tax records and accounts. It covers taxpayer and spouse information, withholding and self-employment status, prior address after a move, and household members over age eighteen. It also provides questions and answers defining earned income tax and listing exempt income types.",{"@graph":63,"@context":118},[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/earned-income-tax-questionnaire-for-berkheimer/304421/",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/earned-income-tax-questionnaire-for-berkheimer/304421.png","ImageObject",442,249,{"name":88,"@type":89},"Emma Mercer","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-24","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":9},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What is the Earned Income Tax and what income does it cover?","Question",{"text":108,"@type":109},"The earned income tax is levied by the resident taxing jurisdiction. Earned income includes salaries, wages, commissions, bonuses, incentive payments, fees, tips, and other service compensation, and it also covers net business profits after operating costs and expenses.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What types of income are specifically exempt from the Earned Income Tax?",{"text":113,"@type":109},"Dividends, interest, trust income, bonds, insurance and stocks are exempt. Also exempt are third-party sick or disability benefits, old-age benefits, retirement pay and pensions (including Social Security payments), public assistance or unemployment compensation, and certain U.S. armed forces service payments.",{"name":115,"@type":106,"acceptedAnswer":116},"If my earned income tax is withheld in another community where I work, do I also pay the district where I live?",{"text":117,"@type":109},"No. The document states that tax withheld by the employer is not also paid to the district in which you live based on the withheld amount.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},304421,1790236988,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":73,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":73,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":9},962084925502,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Earned Income Tax Administrator  \n50 North Seventh Street, Bangor PA 18013  \nEARNED INCOME TAX QUESTIONNAIRE Please complete the reverse side of this form. Detach at perforation and return top portion to Berkheimer within ten (10) days.  \nTo comply with Act 511 and its Amendments, and the Local Tax Resolutions or Ordinances, this questionnaire is necessary and must be answered fully by all residents.  \nYou 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 AM through 4:30 PM, Monday through Friday.  \nName  \nAddress  \nCity  \nState Resident Municipality:  \n&  \nZip  \n Tax Rate:  \nPlease detach and return top portion to Berkheimer  \nDear Taxpayer,  \nWe recently received information indicating that you reside in a school district and/or municipality in which an earned income tax has been levied on wages, commissions, net profits, etc. Berkheimer is the appointed earned income tax officer under the authority of the Local Tax Enabling Act (LTEA), commonly referred to as \"Act 511\". Act 511 is the current state law providing all Pennsylvania municipalities, except Philadelphia, with the right to impose the earned income tax.  \nFounded in 1946 in Bangor, Pennsylvania, Berkheimer is Pennsylvania's largest independent tax collection agency, maintaining several offices throughout the state. Over 1,100 municipalities and school districts process their tax records and payments through Berkheimer .  \nAs the appointed Earned Income Tax collector, we are charged with the duty of administering the school district's and/or municipality's taxes. This includes collecting the tax, establishing rules and regulations to fairly enforce such tax, and creating accurate tax records and accounts for each taxpayer.  \nThe reverse side of this letter contains an earned income tax questionnaire, which is to be completed and returned within ten (10) days. A completed questionnaire will fulfill your registration requirements under the earned income tax rules and regulations, and provide us with accurate tax rolls. More importantly, this information will ensure that your tax dollars are sent to your home taxing jurisdiction. All residents eighteen  \n(18) years of age or over must complete this questionnaire regardless of employment status (unemployed, retired, college student, military personnel, homemaker) . Please include a list of any additional members of your household who are (18) years of age or older. Any individual under the age of eighteen (18), who has earned income, must also complete this questionnaire. If you have recently moved, please give your current and former address.  \nMost resident taxpayers will have this tax deducted by their employers. Although, if you work where it is not withheld or you are self-employed, you will have to pay the tax directly to Berkheimer. After we receive your completed questionnaire, we will send you the necessary tax forms and create an accurate tax account reflecting your correct reporting status.  \nWe appreciate your cooperation in returning this questionnaire. Kindly refer to the back of this letter for general questions and answers about the earned income tax. Should you have any additional questions, you may contact our office at the telephone number(s) listed above. We will be happy to assist you.  \nSincerely,  \nBerkheimer  \nEarned Income Tax Administrator  \nquest.qxd rev. 6/01  \nYour Social Security No. ~~ ~~ Spouse's Social Security No. ~~  ~~Address   City   State   Zip   Telephone Number    \nTaxing Jurisdiction  Municipality (Twp/Boro/City) School District  How long have you lived at this address?  / /  to  / /  (If less than 2 years, enter previous address below)  \nYOUR INFORMATION  \nPrevious Address   Employer's Name   Working Jurisdiction (Twp/Boro/City) ~~ ~~  \nIs this Earned Income Tax withheld from your pay?  YES  NO  \nAre you Self-employed?  YE","cbCaiimzLY57ShFi","https://ap.wps.com/l/cbCaiimzLY57ShFi","pdf",51897,"English","# Earned Income Tax Questionnaire Instructions\n## Return Requirements and Act 511 Background\n## Taxpayer and Spouse Information\n## Questions and Answers on Earned Income Tax","[{\"question\":\"What is the Earned Income Tax and what income does it cover?\",\"answer\":\"The earned income tax is levied by the resident taxing jurisdiction. Earned income includes salaries, wages, commissions, bonuses, incentive payments, fees, tips, and other service compensation, and it also covers net business profits after operating costs and expenses.\"},{\"question\":\"What types of income are specifically exempt from the Earned Income Tax?\",\"answer\":\"Dividends, interest, trust income, bonds, insurance and stocks are exempt. Also exempt are third-party sick or disability benefits, old-age benefits, retirement pay and pensions (including Social Security payments), public assistance or unemployment compensation, and certain U.S. armed forces service payments.\"},{\"question\":\"If my earned income tax is withheld in another community where I work, do I also pay the district where I live?\",\"answer\":\"No. The document states that tax withheld by the employer is not also paid to the district in which you live based on the withheld amount.\"}]","Earned Income Tax Questionnaire - For Berkheimer | PDF",1789813077]