Employers Annual Summary

Southwest Regional Tax Bureau
Employer Annual
Summary Wage Tax Report
Year End - Due February 28th

Click here to download and print Employer Year End Summary Forms in PDF format

Or, you can fill in and print the form below. (Please note that any information that you type into this form will NOT BE SAVED!)

EMPLOYERS ANNUAL SUMMARY WAGE TAX REPORT

Year End - Due February 28th

This form must accompany W-2 forms or a complete detailed listing of the employees for whom you have withheld local tax and have remitted to our office.

Account Number:
Employer Name:
Address:

City/State/Zip:
Phone Number:

1. Total Number of W-2 Forms Attached:
2. Total amount of Local Tax Withheld as shown on W-2 Forms	$

Total Income Tax Withheld as Reported on Employer's Quarterly Returns (Form IT-8E)
A. Quarter ending March 31st.	$
B. Quarter ending June 30th.	$
C. Quarter ending September 30th.	$
D. Quarter ending December 31st.	$
3. Total amount remitted for Quarters 1 - 4	$
Please Attach a Detailed Explanation of Any Discrepancies Between Lines 2 and 3.

Under penalties of perjury, I declare that I examined this return including accompanying schedules and statements, and to the best of my knowledge are true and correct.
Signature:
Date:

Please make checks or money orders payable to: Southwest Regional Tax Bureau (S.W.R.T.B.)

PENNA.ACT #511 is quoted in part:
On or before February 28, of the succeeding year, every employer shall file with the officer: A return withholding statement for each employee employed during all or any part of the period beginning January 1, and ending December 31, of the current year, setting for the employee's name, address, and S.S. Number, the amount of Earned Income paid to the employee during said period, the amount of Tax deducted and the amount of Tax paid to the officer, every employer shall furnish two copies of the individual return of the employee for who it is filed.

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This page last modified on 03/28/08