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If yes, check here and see back of form.  \n*COPY*  \nName Address City State &  \nZip  \nTo file online, [visit](visit www.berk-e.com)[ www.berk-e.com](visit www.berk-e.com)  \nACCOUNT \\# EMAIL  \nEMAIL:  \n(internal)  \nFM   \nEXTENSION  AMENDED RETURN   \n\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n\n\n| DAYTIME/MOBILE PHONE NUMBER* RESIDENT PSD CODE\u003Cbr>\u003Cbr>* By providing your phone number, you consent to be contacted regarding your account via this number.\u003Cbr>Only use BLACK or BLUE ink to complete this form.\u003Cbr>Please do not submit copies of this form.\u003Cbr>Do not use staples.\u003Cbr>l There will be a $29.00 fee for returned payments.\u003Cbr>l Penalty, interest and additional fees will be assessed if no payment is enclosed for tax due at time of filing. The calculations reported in the first column MUST pertain to the name printed in the column, regardless of which spouse appears first. Combining income is NOT permitted.\u003Cbr> Single  Married, Filing Jointly  Married, Filing Separately | Enter Social Security \\# A\u003Cbr>|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | ENTER SPOUSE’S NAME\u003Cbr>Enter spouse’s Social Security \\#\u003Cbr>\u003Cbr>B\u003Cbr>|\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| 1. Gross Compensation as Reported on W-2(s) . (Enclose W-2(s)) .........................\u003Cbr>2. Unreimbursed Employee Business Expenses. (Enclose PA Schedule UE) ...........\u003Cbr>3. Other Taxable Earned Income * ..........................................................................\u003Cbr>4. Total Taxable Earned Income (Subtract Line 2 from Line 1 and add Line 3) ....\u003Cbr>5. Net Profit (Enclose PA Schedules*) ...................................................................... NON-TAXABLE S-Corp earnings check this box: \u003Cbr>6. Net Loss (Enclose PA Schedules*) ........................................................................\u003Cbr>7. Total Taxable Net Profit (Subtract Line 6 from Line 5. If less than zero, enter zero)  \u003Cbr>8. Total Taxable Earned Income and Net Profit (Add Lines 4 and 7) .........................\u003Cbr>9. Total Tax Liability (Line 8 multiplied by ) . .........................\u003Cbr>10. Total Local Earned Income Tax Withheld (MAY NOT EQUAL W-2-SEE INSTRUCTIONS)*\u003Cbr>11. Quarterly Estimated Payments/Credit From Previous Tax Year.........................\u003Cbr>12. Out of State or Philadelphia credits* (include supporting documentation)  \u003Cbr>13. TOTAL PAYMENTS and CREDITS (Add lines 10 through 12) .....................\u003Cbr>14. Refund IF MORE THAN $1 .00, enter amount (or select option in 15) .................... If you calculate a refund due, you may be denied. Please see Line 10 instructions.\u003Cbr>15. Credit Taxpayer/Spouse (Amount of Line 14 you want as a credit to your account) . ........  Credit to next year  Credit to spouse\u003Cbr>16. EARNED INCOME TAX BALANCE DUE (Line 9 minus Line 13) ....................\u003Cbr>17. Penalty after due date (multiply line 16 by 0 x number of months (ora fraction of) late)..\u003Cbr>18. Interest after due date (multiply line 16 by x number of months (ora fraction of) late).\u003Cbr>19. TOTAL PAYMENT DUE (Add Lines 16, 17, and 18) Payable to HAB-EIT ......... |  |  | , |  |  |  |  |  | , |  |  |  |  | .0 |  | 0  |  |  | \u003Cbr>, , |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  | 0 |  |  |  |\n|  |  |  | , |  |  |  |  |  |  | , |  |  |  | . |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  | 0 |  |  |  |\n|  |  |  | , |  |  |  |  |  |  | , |  |  |  | . |  | 0  |  |  |  |\n|  |  |  | , | ","cbCainZ6U7RwgHtw","https://ap.wps.com/l/cbCainZ6U7RwgHtw","pdf",300945,"English","# Taxpayer Annual Local Earned Income Tax Return\n## Resident jurisdiction and tax year details\n## Personal and spouse information\n## Payment, credits, refund, and balance due calculations\n## Penalties, interest, and filing instructions","[{\"question\":\"What should I do if I moved during the tax year?\",\"answer\":\"Check the appropriate box for moving during the year and follow the instructions referenced on the back of the form.\"},{\"question\":\"How are payment due amounts calculated on this return?\",\"answer\":\"Total payment due is computed by adding the earned income tax balance due (Line 16), penalty after due date (Line 17), and interest after due date (Line 18).\"},{\"question\":\"What are the filing instructions for completing the form?\",\"answer\":\"Complete the form using black or blue ink only, do not submit copies, and do not use staples.\"}]","TAXPAYER ANNUAL LOCAL EARNED INCOME TAX RETURN | PDF",1789779646]