Southwest Regional Tax Bureau
Individual Earned Income Final Return Form
Please note that any information that you input to this form will NOT be saved, so be sure to print the form upon completion.
PSDI:    Tax Year:   Tax Rate:   
Address: School District:
Municipality:
City/State/Zip:
Name:

S.S.#:
--		 Spouse's Name:

Spouse's S.S.#:
--
Individual Information For Tax Office Use ONLY Spouse's Information For Tax Office Use ONLY
1. Earned Income/Compensation (Gross Wages): $ ID:   $ ID:  
2. Net Profits or Loss (Schedule C, K, I, F): $ Check/ MO:   $ Check/ MO:  
3. Earned Income From Other Sources: $ Cash:   $ Cash:  
4. S-CORP Income (Not Taxable) Schedule RK1: $ Tax:   $ Tax:  
5. Less Allowable Business Expense UE/2106: $ () Interest:   $ () Interest:  
6. Taxable Earned Income (lines 1 through 5): $ Penalty:   $ Penalty:  
7. Tax Due (Multiply Line 6 by Local % Tax Rate): $ Liab.:   $ Liab.:  
8. Total Local Wage Tax Withheld by Employer: $ () PSDI:   $ () PSDI:  
9. Quarterly Tax Paid to this Office: $ ()     $ ()    
10. Total Credits (Add Lines 8 and 9): $     $    
11. Tax Due (If Line 7 is greater than Line 10): $     $    
12. Refund (if line 10 is greater than Line 7): $ Refund:   $ Refund:  
13. Credit/Overpayment of $10.00 or less applied to next year: $ Credit:   $ Credit:  
14. Residence Date From:      Year: To:      Year:
15. Check here if Part Year Resident Please indicate address changes and dates here:
School District/Municipality: Date From: Date To:
Mail Check or Money Order Payable to:
SWRTB		 Amount of Enclosed Check: $
Under penalties of perjury, I declare that I examined this return, including accompanying schedules and statements, and it is, to the best of my knowledge and belief, true and correct.
Signature Taxpayer 1:

 Date:

 Home Phone Number:
()- 		Employer:
Signature Taxpayer 2:

 Date:

 Cellular Phone Number:
()- 		Employer:
Please note that there will be a $10.00 fee if payment is not enclosed for the amount due on or before the due date.



Click here to download a Final Return form in PDF format

Please read instructions carefully.

Final Earned Income Tax Instructions

Section I.

  1. This form must be completed and filed by April 15. Even if the entire local income tax was withheld by your employer and/or no tax is due.
  2. Please file the same tax return that was sent to you. Be sure that your Social Security number is correct on the form. Make sure all information is updated (i.e. Name, Address, School District, Municipality, Telephone number, etc.). Each individual taxpayer must file a return. Combining incomes is not permitted.
  3. Improperly executed or unsigned forms will be considered delinquent. Forms must show the actual taxable income, the tax due, the total payment enclosed (if applicable), the name of the resident taxing district (school district and municipality), the amount of time that you lived in the area during tax year, and so on. Copies of the appropriate federal and state tax schedules and W-2 forms must be attached for all earned income.
  4. Failure to receive a tax form does not excuse a taxpayer from filing the return or paying the tax due.
  5. For checks dishonored for any reason, there will be a $35.00 processing fee charged.
  6. NOTE: All accounts are subject to an audit and review. Failure to properly complete, sign, and file this notice with this office may upon conviction thereof, subject the taxable to a fine of $500.00 plus costs and/or 30 days in jail. (P.L. 1257 Section 12, IX)
  7. Tax due - Payment in full must be remitted with return. There will be a $10.00 fee if payment is not enclosed at time of filing.
  8. Non-Taxable Income: Pension, unemployment, sub-pay, bank interest, 3rd party sick pay and disability, S-Corp., and passive partnership.

Section II.

  1. Compensation: Gross earnings paid or received during the tax year. Taxable income includes, but is not limited to, wages, salaries, bonuses, tips, vacation pay, and reserve military pay in PA.
  2. Net Profits: Income through self-employment, net profits from farming, non-passive partnerships, etc.
  3. Earned Income from Other Sources: Commissions, tips, fees, stock options, severance pay, stipends, lump sum distribution from profit sharing, 401 K plan, and any other earned income.
  4. S-Corp / Non-Taxable Income: Schedule RK1 or K1 (11205). Form must be attached.
  5. Legitimate Un-Reimbursed Business Expense: May be deducted form gross amount provided a complete schedule of said expenses is attached (UE, 2106, etc.) together with taxpayer's certification in writing that the expenses were not reimbursed and were normal and necessary for the taxpayer to maintain their job for the year.
  6. Total Taxable Income
  7. (%) Percentage Rate times line 6.
  8. Total Local Wage Tax Withheld by Employer.
  9. Quarterly Payments to SWRTB: If your earned income tax is not withheld: You are required to file and remit 85% of the tax due quarterly in order to avoid interest and penalty charges. A balance of $1.00 or less should not be remitted.
  10. Add Lines 8 and 9.
  11. Tax due: Must remit with this form at the time of filing.
  12. Refund request: Refunds will not be honored without all proper documents attached.
  13. Credit: Valid refunds of $1.01 to $10.00 will be credited to the next year.
  14. School District and Municipality of Residence: Please indicate the school district and municipality in which you resided during this tax year.
  15. Part Year Residents: If you moved during this tax year please provide address and dates.

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This page last modified on 4/7/08

Questions or problems regarding this web site should be directed to [swrtb@lcsys.net].
Copyright © 2002 (Southwest Regional Tax Bureau) All rights reserved.
Last modified: 4/7/08.