PDF document
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 2020 TAX RETURN 

 SPECIFICATIONS 

 and Payment Coupon 

 Scanline Information  



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 2  
     
                   Table of Contents 

 Design Specifications Instruction Page…………………………………………………………….3 
 Scan Line Specifications for Payment Coupons………………………………………………..5 
 City of Philadelphia Change Form…………………………………………………………………….8  
 Annual Employee Earnings Tax 
    2020  Annual  Earnings  Instructions  Page…………………………………………..….. 10 
    Earnings Tax Return Specifications……..………………………………………………… 12 
    Tax Return Design Sample: 2020 Earnings Tax.…………………………………….. 13 
    Earnings Payment Coupon Scan Line Data.…………………………………………… 15 
    Payment Coupon Design Sample: 2020 Earnings Tax………………………………. 16 
 Annual Employer Wage Tax 
    2020 Annual Wages Instructions Page………………………………………………….. 17 
    Wage Tax Return Specifications…..……………………………………………………….. 19 
    Tax Return Design Sample: 2020 Wage Tax………..………………………………… 20 
    Wage Payment Coupon Scan Line Data…………………………………………………. 21 
    Payment Coupon Design Sample: 2020 Wage…………………………………………. 22 
 School Income Tax 
    2020 School Income Tax Instructions Page……………………………………….…… 23 
    School Income Tax Return Specifications.……………………………………….……… 25 
    Tax Return Design Sample: 2020 School Income Tax…………………….……….. 26 
    2020  School  Income  Tax  Worksheet………………………………………………..…… 27 
    School Income Tax Payment Coupon Scan Line Data…………………………….. 28 
    Payment Coupon Design Sample: 2020 SIT.………………….…………………………. 29 
 Business Income and Receipts Tax & Net Profit Tax 
    2020 Business Income & Receipts & Net Profit Tax Instructions Page……. 30 
    BIRT  Tax  Return  Specifications………………………………………………………………  32 
    Tax Return Design Sample: 2020 BIRT………..………………………………………… 40 
    BIRT-EZ Tax Return Specifications…………..…………………….……………….……….. 48 
    Tax  Return  Design  Sample:  2020  BIRT-EZ.….……………………………………….  50 
    BIRT Extension Payment Coupon Scan Line Data…………………………………… 52 
    BIRT Payment Coupon Scan Line Data……………………...………………………….. 53 
    Payment Coupon Design Samples: 2020 BIRT & BIRT Extension.…………… 54 
    Net Profit Tax Return Specifications………………….……………………………………. 55 
    Tax Return Design Sample: 2020 NPT…………………………………………………… 56 
    NPT Extension Payment Coupon Scan Line Data……………………………………. 60 
    NPT Payment Coupon Scan Line Data……………………...…………………………… 61 
    Payment Coupon Design Samples: 2020 NPT & NPT Extension..…………….... 62 
     st nd 
    NPT 1 & 2 Estimated Payment Coupon Scan Line Data....……………………… 63 
                                                   st nd 
    Payment Coupon Design Samples: 2021 NPT 1 & 2 Estimated..…………... 65 
    2020 No Tax Liability BIR Tax Return Specifications………………….……………... 66  
    Tax Return Design Sample: 2020 BIR NTL ………………………………………………. 67
                              www.phila.gov/revenue 
        For general information call Taxpayer Services at 215-686-6600. 



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                             City of Philadelphia Department of Revenue 
                             Design Specifications, Samples and Instructions 
 
 The following guidelines must be followed for reproduced or substitute City of  Philadelphia  Department of Revenue 
 tax returns. The purpose of these guidelines is to ensure that the reproduced or substitute forms are compatible with 
 the Department's processing system, and that they present information in a  uniform manner. Please know that not 
 complying to these guidelines will cause a delay in the processing of taxpayer forms filed. Schedules retained by the 
 taxpayer, instructions and the Change Form are included for your convenience. 
 Physical submissions made via mail should be sent to: 
 
 Tevan Jackson (FPU Supervisor) 
 City of Philadelphia Department of Revenue 
 Municipal Services Building - Concourse Level 
 1401 John F. Kennedy Boulevard Philadelphia, PA 19102 
 
 *Links sent that require creating accounts to access encrypted sites or forms will be disregarded* 
 
 Specific questions and concerns for the following topics should be directed to the listed Revenue staff: 
 Design Specifications: Darius Thomas at Darius.Thomas@phila.gov 
 Coupon Scanline Data: Prakash Gowda at Prakash.Gowda@phila.gov or Kurian Chirackel at Kurian.Chirackel@phila.gov 
 All Electronic Submissions: Darius Thomas at Darius.Thomas@phila.gov 
 For information regarding Tax Regulations: Visit our website at www.phila.gov/revenue. 
 For all other questions, concerns or general information call Taxpayer Services at 215-686-6600. 
 
 Each page is measured 85 characters across (X), 66 characters down (Y). 
 Each  page  has  aRegistration  Markin  each  of  the  four  corners. Each mark is aSquarethat measures3/16 of 
 an inch. 
 
 Printing  Forms: Software  must  inform  taxpayer  to  send  the  originally  printed  form  and  not  a  photocopy  for 
 processing. Printed  forms  from software should require  the  taxpayer  to select  the following  printing  choices before 
 the  printing  option  can  be  chosen: 
 “Actual Size” must be selected. “Print on Both Sides” must be unchecked. 
 Page Size: Reproduced or substitute forms must be printed on 8 1/2" x 11" paper. 
 Font Size: The preferred font and size to use for all entries of variable data is OCR A II or Extended 12 pt. 
 Form Numbers: Form numbers shall be printed using 3 of 9 barcode (Code 39). 
 Two-Sided Forms: Reproduced or substitute forms may be printed on one side or both sides of the paper. 
 Rounding  and  Number  formatting:      All  amounts  should  be  numeric  only  and  right  justified.  If  the  field  is  zero, 
 leave  blank.  All  amounts  filled  in  on  these  forms  should  be  rounded  to  the  nearest  dollar  (drop  amounts  under 
 50¢  and  increase  amounts  that  are  50¢  or  more  to  the  next  dollar). In  dollar  amount  entries  do  not  include  a 
 dollar  symbol, a  cent  symbol or  any commas. Do  not use  parentheses, brackets, the  minus  sign  or  the word 
 “loss”  for  negative  numbers. Where  appropriate,  lines  indicating  a  negative  number  will  have  an  “X”  placed  at 
 the beginning of that line. 
                                            Changes for 2020 Testing 
 
 1.  A physical copy of all test submissions will need to be sent for testing (mailing instruction above) 
 2.  Testing has been split into a 2 Phase Approval process: 
 •      Phase 1: Alignment Testing – This test will consist of full-field submissions (see associated Tax Return 
        Design Samples) to confirm positioning of printed taxpayer data. 
 •      Phase 2: Sample Data & Calculations Testing – This test will consist of specific series of values which 
        will  be  assigned  for  each  return  type.  Each  test  is  assigned  to  one  testing  account  number.  Testing 
        accounts used must be the expected account number; test data varies for each vendor. 
 3.  Unique Account Numbers, EIN’s & SSN’s will be provided for testing. *If you did not participate in testing 
 for the 2019 Tax Season you will need to request Testing Data* 
 
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                     Important Information for Filing Business Income and Receipts Tax 
 
 If all business is conducted and/or located within Philadelphia, only the BIRT-EZ Pages 1 and 2          should be 
 completed, printed and filed. 
 
 If  business  is  conducted  and/or  located  both  in  and  out  of  Philadelphia,  the  BIRT  Page  1  and  the 
 appropriate  combination  of  Schedules  A  through  E      should  be  completed,  printed  and  filed.  Tax 
 practitioners should be able to print Page 1 and all completed schedules without restrictions. 
 
 Taxpayers must use the same method (Schedule A, Method I or Schedule B, Method II) that they elected 
 on the first Business Income & Receipts Tax return filed.  Only Schedule A (Form 24715) or Schedule B 
 (Form 24415) should be completed, printed and filed. 
 
 Schedule  C-1  –  Computation  of  apportionment  factors  to  be  applied  to  apportionable  net  income.  You 
 must complete Schedule C-1 if you are apportioning your income.  Failure to include this schedule with 
 the  return  may  result  in  the  disallowance  of  your  apportionment  and  you  may  be  billed.  Schedule  C 
 should not be completed or filed if the BIRT-EZ return is used. 
 
 If Line 12 of Schedule C-1 of the Business Income and Receipts Tax Regular return is equal to 100%, the 
 BIRT-EZ  return  must  be  used  instead.  Schedule  C-1  should  not  be  completed  or  filed  if  the  BIRT-EZ 
 return is used. 
 
                                                  Payment of Tax Due 
 
 Payment of tax due should be made using payment coupons.          Taxpayers must include a coupon for proper 
 credit and       timely processing.       Payment      coupons    can     be    printed   on-line by     going to  
 https://ework.phila.gov/revenue. 
 
 Payment of tax due can be made by credit card or e-check at www.phila.gov/revenue.  A user fee of 2.00% 
 is added when paying by credit card, and 3.95% when paying by debit card. E-CHECK IS FREE. 
 
 ACH  Debits  and  Credits  are  accepted  for  payment  of  Business  Income  and  Receipts  Tax.  For  more 
 information or to enroll in this program go to    www.phila.gov/revenue and click “Payments & E-File” then 
 select  “Pay  Taxes”.  Contact  the  Electronic  Government  Unit  at  215-686-6582,  6628  or  6459  or  e-mail  
 egovservices@phila.gov. 
 
 Returned  Checks.   If  your  check  is  returned  unpaid  for  insufficient  or  uncollected  funds,  (1)  you  authorize 
 The City of Philadelphia or its agent  to  make  a  one-time  electronic  funds  transfer  from  your  account  to  collect 
 a fee of $20; and (2)  The  City  of  Philadelphia  or  its  agent  may  re-present  your  check  electronically  to  your 
 depository institution for payment. 
 
 The scan line is 68 characters in length, the 68thcharacter being a check digit using the mod 10 routine and must 
 be printed in 12 pt. OCR-A font.  The bottom edge of the scan line must print 1” from the bottom of the coupon 
 and 3/8” from the right edge of the coupon (start position X=14, Y=60).  Examples of coupons for each tax type 
 are provided in this package. 
 
 Sample coupons must be submitted to verify placement of variable data and validity of the scan line check digit. 
 
 Taxpayers  and  practitioners  seeking  a  technical  tax  consultation  with  the  Technical  Staff  must  submit  their 
 questions via e-mail to revenuetaxadvisors@phila.gov. Inquiries regarding tax notices, tax bills, and tax account 
 information maintenance/changes should be made to the Taxpayer Services Area of the Department. Taxpayer 
 Services phone number is 215.686.6600. Their e-mail address is      revenue@phila.gov.  Basic tax questions (e.g. 
 an explanation of or the calculation of Business Privilege Tax taxable gross receipts and apportioned/taxable net 
 income, taxable Net Profits, taxable Philadelphia Wages, filing Wage and Business Tax Refund petitions, etc.) 
 can  be  e-mailed  to  the  Audit  Division  at  revenueaudit@phila.gov.  The  Audit  Division  telephone  number  is 
 215.686.6500.    Please research the Department’s website at www.phila.gov/revenue and the Technical Rulings 
 / Tax Regulations link before e-mailing your question. 
 
                                           Revised November 19, 2019 

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      Scan Line Specifications for Vendor Reproduced Payment Coupons 

Certain guidelines must be followed for reproduced or substitute City of Philadelphia Department of 
Revenue tax coupons. The purpose of these guidelines is to ensure that the reproduced or substitute 
forms are compatible with the Department's processing system, and that they present information in a 
uniform manner. 

As part of the Revenue Department’s modernization project, the department is adding 2-D barcodes 
to  our  payment  coupons.  The  barcodes  will  allow  for  faster  and  more  accurate  processing  of 
payments. Effective with the 2018 tax year payments, all coupons must contain a 2-D barcode and a 
68-character scanline. 

The  following  are  guidelines  for  substitute  and  reproduced  tax  payment  coupons.  Following 
these guidelines will help speed the approval process and processing of taxpayer payments. It 
is recommended that submission be made using .pdf files as e-mail attachments. 

Each page is measured 85 characters across (X), 66 characters down (Y) using the NACTP 10 x 6 
grid. 

Each coupon must have registration targets in each of the four corners. The marks measure 3/16 of 
an  inch  square.  The  marks  should  be placed  ¼  inch from  the  top  and  sides  and  ½  inch  from  the 
bottom of each printed coupon. 

The scan lines of reproduced payment coupons will be a 2-D barcode in PDF417 format.  The scan 
                               th 
line  is  68  characters  in  length,  the  68 character  being  a  check  digit  using  the  mod  10  routine. 
Stretching or scaling the barcode changes its integrity and reduces the readability of the barcode; it 
should not be done. 

If a software developer does not support 2-D barcodes, the area reserved for the barcode should be 
left blank and the scan line must be printed in 12 pt. OCR-A font.  The bottom edge of the scan line 
must print 1” from the bottom of the coupon and 3/8” from the right edge of the coupon (start position 
X=14, Y=60).  The scan line layout and examples of coupons for each tax type are provided in this 
package. 

Sample coupons must be submitted to verify placement of variable data and validity of the scan line 
check digit and/or barcode. 

                               Revenue for Schools and Services 

                                  Revised 11-5-2018 

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                               2D Barcode Details 

1. Required Type of 2D Barcode:
a. PDF417.
2. Encoded contents of 2D Barcode:
a. 3 digit‐ form ID (unique to each coupon type) concatenated with the payment coupon 
   scanline. Form ID’s are listed below.
3. Position of 2D Barcode:
a. Upper left corner should begin at 0.9 inches from the left of the coupon, and 8.85 inches 
   from the top of the coupon.

            Tax Type                 Abbreviation                    Form ID 
Earnings                                   ERN                       201 
Business Income and Receipts Tax           BIR                       202 
Net Profits Tax                            NPT                       203 
Wage Tax                                   WAG                       204 
Amusement                                  AMU                       205 
Parking                                    PRK                       206 
Valet Parking Tax                          VPT                       207 
Vehicle Rental Tax                         VRT                       208 
Outdoor Advertising Tax                    OAT                       209 
School Income Tax                          SIT                       210 
Hotel                                      HOT                       211 
Liquor                                     LIQ                       212 
Current Real Estate Tax                    REA                       213 
Delinquent Real Estate Tax                 REA                       214 

                                  Revised 12-24-2018 

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                                      Check Digit Calculation 
 
 The scan-line is 68 positions, all numeric, with the Check-Digit in position 68. To calculate the Check- 
 Digit, do the following: 

 1. For each position 1 through 67, assign a numeric value to the position based on the contents of 
    the position and whether the position itself is even or odd. 
 2. Add the assigned value for each position into a total. 
 3. Compute the Check-Digit total as 700 minus the final total. 
 4. Accept the unit digit of the Check-Digit total as the Check-Digit 
 
 Assigning the numeric value to even positions 

 1. For even positions 2, 4, 6, …, 66 accept the value of the position as the assigned numeric value. 
         a. For a value of 0, the assigned numeric value is 0 
         b. For a value of 1, the assigned numeric value is 1 
         c. For a value of 2, the assigned numeric value is 2 
         d. For a value of 3, the assigned numeric value is 3 
         e. For a value of 4, the assigned numeric value is 4 
         f.   For a value of 5, the assigned numeric value is 5 
         g. For a value of 6, the assigned numeric value is 6 
         h. For a value of 7, the assigned numeric value is 7 
         i.   For a value of 8, the assigned numeric value is 8 
         j.   For a value of 9, the assigned numeric value is 9 
 
 Assigning the numeric value to odd positions 

 1. For odd positions 1, 3, 5, …, 67 compute the assigned numeric value as follows: 
         a. Multiply the value of the position by 2 
         b. Where the resulting value is greater than 9, add 1 to the unit value. 
                  i. For a value of 0;  The assigned numeric value is 0. 
                  ii. For a value of 1;  The assigned numeric value is 2. 
                 iii. For a value of 2;  The assigned numeric value is 4. 
                 iv. For a value of 3;  The assigned numeric value is 6. 
                  v. For a value of 4;  The assigned numeric value is 8. 
                 vi. For a value of 5;  The assigned numeric value is 1. 
                 vii. For a value of 6. The assigned numeric value is 3. 
                 viii. For a value of 7; The assigned numeric value is  5. 
                  ix. For a value of 8;  The assigned numeric value is 7. 
                  x. For a value of 9;  The assigned numeric value is 9. 

 Example 

 For the following 68 position Scan-Line, where the Check-Digit in position 68 has not yet been assigned: 

 333010415140000000013484990000000000000000007777681140000000000000 0

 1. The total of all assigned numeric values for positions 1 to 67 is 122. 
 2. The Check-digit total is 700 minus 122 = 578. 
 3. The Check-Digit is the unit value of 578, or  .8

 With the assigned Check-Digit, the final scan-line will appear as follows: 

 333010415140000000013484990000000000000000007777681140000000000000 8




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                                                   CITY OF PHILADELPHIA DEPARTMENT  OF REVENUE 

                                                                 CHANGE FORM 
                     USE TO UPDATE ACCOUNT INFORMATION OR TO CANCEL A TAX LIABILITY 
 
                                                       MAIL THE COMPLETED CHANGE FORM TO: 
             CITY OF PHILADELPHIA, DEPARTMENT OF REVENUE,  P.O. BOX 1410, PHILADELPHIA, PA, 19105-1410 

                PHONE:   215(           686-6600)         E-MAIL:  revenue@phila.gov                         INTERNET:  www.phila.gov/revenue           
 
 Businesses complete Sections 1 and 2 to add a tax, or to close a business account.  For a change of entity you must cancel 
 your account and apply for a new Tax Account Number and Commercial Activity License. Contact the department to obtain an 
 application or to register on-line visit our website            www.phila.gov/revenue. For property subject to Use and Occupancy Tax 
 complete Section 3. Individuals complete Section 4 for School Income Tax or Section 5 for Employee Earnings Tax. 
 
  Section 6 must be completed for all requests including the signature of the preparer of this form. 
 
 Section 1 - Business Tax Registration Information. 
  Currently Registered Business Name and Address                                          Corrected Business Name and Address           
                                                                                                                                        
  City Account Number                      Employer Identification Number                       City Account Number         Employer Identification Number 
                                                   -                                                                           - 
                                Social Security Number                                                           Social Security Number 

                                -          -                                                                              -    - 
                        Spouse's Social Security Number                                                          Spouse's Social Security Number 

                                -          -                                                                              -    - 
 
 Section  2  -  Add  a  tax,  o cancelr an account.       If your  business has  closed,  enter the last day of business:               -         - 

  If your business never                                                          To add a new tax type, enter the start date:          -         - 
  materialized,  check  here:                                              
                                                      ADD        CANCEL                                                        ADD          CANCEL 
 
  AMUSEMENT TAX                                                                                 PARKING TAX 
  BEVERAGE TAX                                                                                  TOBACCO TAX 
  BUSINESS INCOME  &  RECEIPTS  TAX                                                             USE & OCCUPANCY TAX 
  HOTEL TAX                                                                                     VALET PARKING TAX 
  NET PROFITS TAX                                                                               VEHICLE RENTAL TAX 
  OUTDOOR ADVERTISING TAX                                                                       WAGE TAX 
                                                                                                                 
 Section 3 - For property subject to Use and Occupancy Tax.       
                                                                                                                 Business U&O Tax Account Number 
  Property Address       
                         
                                                                                                                                        - 
 
                                                                                                                   Property Account Number 
 
                                                                                                                          Cancellation Date 
  Use and Occupancy Tax Mailing Address  (If different from Property Address)       
                                                                                                                          -    - 

                                                                                                                          Date of Purchase 

                                                                                                                          -    - 
 
  Check Reason for Cancellation:                                                      
                        Sold                         Residential                                Name of New Property Owner 
                        Vacant                       Other (Explain in Section 6) 
                                                                                                                               83-E669 COP Change Form Rev. 10-19-2020 
 



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 Section 4                                         SCHOOL INCOME TAX 
  If the preprinted information listed on your tax return is incorrect, use this form to make the necessary corrections.  For example, if your spouse 
  is deceased and you filed jointly with your spouse, use the Change Form to indicate your name and Social Security number. 
 
  Currently Registered Taxpayer Name and Address      Corrected Taxpayer Name and Address       
                                                                                                
                 Social Security Number                                         Corrected Social Security Number 

                          -   -                                                   -          - 
                                                     
               Spouse's Social Security Number                                  Corrected Spouse's Social Security Number 

                          -   -                                                   -          - 
 
                                                                                              Cancellation Date 
  Reason         Moved out of Philadelphia            Spouse Filing Separately 
  for 
  Cancellation   Deceased.  Enter date of death    _  No taxable Income                       -                               - 
 
 Section 5                                         EMPLOYEE EARNINGS  TAX 
 
  Currently Registered Taxpayer Name and Address      Corrected Taxpayer Name and Address       
                                                                                                
                 Social Security Number                                         Corrected Social Security Number 

                          -   -                                                   -          - 
 
                                                                                             Cancellation Date 
  Reason         Moved out of Philadelphia         Employer now withholding tax 
           for 
  Cancellation   Deceased                          No longer employed                       -                               - 
 
 Section 6                      State the reason for submitting this change form: 
 
                              Contact information must be completed for all change requests. 
 
               Form Completed By (print name):                                    Date 
 
               Signature:                                                         Telephone # 
 
               E-mail Address                                                     Fax # 




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           ANNUAL RECONCILIATION OF EMPLOYEE EARNINGS TAX INSTRUCTIONS
Residents of Philadelphia who received compensation and wage tax was not deducted on gross compensation and Nonresidents who 
have received compensation for services performed in Philadelphia and wage tax         was not deducted on that compensation must file this 
return. Gross  compensation  includes  wages,  commissions,  tips,  bonuses,  severence  pay,  sick  and/or  vacation  pay,  non-cash 
compensation, and military reserve pay excluding active duty.         Employee    Pension plan contributions (such as 401k contributions) 
are subject to wage tax and are not deductible from gross compensation.

Eligibility for Reduced Rate and PA 40 Schedule SP – To receive a decreased Resident or Nonresident Rate, you must file Schedule
SP with the state and be approved.  Generally, to be eligible under Schedule SP, you must meet the following income requirements
based on your marital and federal filing status, number of dependents and income.  Include SP Schedule with filing.

                                               SCHEDULE SP ELIGIBILITY INCOME TABLE
                             Number of                         Unmarried, Separated                          Married
                          Dependent Children                       and Deceased                    (Even if filing separately)
                             0                                             $8,750                            $15,250
                             1                                        $18,250                                $24,750
                             2                                        $27,750                                $34,250
                             3                                        $37,250                                $43,750
                             4                                        $46,750                                $53,250
                             5                                        $56,250                                $62,750
                             6                                        $65,750                                $72,250
                             7                                        $75,250                                $81,750
                             8                                        $84,750                                $91,250
                             9                                        $94,250                                $100,750

The Annual Reconciliation of Employee Earnings Tax for 2020 is due on or before        April 15, 2021 Failure.           to file and pay by this 
date will result in the imposition of interest and penalty         .  Sign the return, enclose W-2 forms, PA Schedule SP (if applicable) and 
mail to: Philadelphia Department of Revenue, P.O. Box 1648, Philadelphia, PA 19105-1648.

If the tax due on Line 20 of the return is $1 or more, make a check payable to "City of Philadelphia". Include the last 4 digits of your Social 
Security Number on your check or money order.  If your check is returned unpaid for insufficient or uncollected funds, (1) you authorize 
The City of Philadelphia or its agent to make a one-time electronic funds transfer from your account to collect a fee of $20; and (2) The 
City of Philadelphia or its agent may re-present your check electronically to your depository institution for payment.

ACH  Debits  and  Credits  are  accepted  for  payment  of  tax.    For  more  information  or  to  enroll  in  this  program  go  to  www.phila.gov/
revenue/eft-ach. Contact the Electronic Government Unit at 215-686-6582, 6479 or 6628 or e-mail to   egovservices@phila.gov.

    If wage tax was overwithheld by your employer, do not file this return.  File the Employee Wage Tax Refund Petition. 
    To download a Refund Petition, go to www.phila.gov/revenue in the "Tax Forms & Instructions" section.    

    IF LINE 17 OF THE RETURN IS GREATER THAN LINE 16 (100% EMPLOYER WITHHELD), DO NOT FILE THIS RETURN. 
    COMPLETE A CHANGE FORM TO CANCEL YOUR ACCOUNT.

Do not staple the tax return.  Do not submit photocopies of this return.  Complete and submit a Change Form to report a mailing address 
change or to cancel your account at www.phila.gov/revenue/tax-change.

If you have questions about this return call 215-686-6600 or send an e-mail to   revenue@phila.gov.  Additional tax returns, instructions,
refund petitions and the Change Form can be downloaded at   www.phila.gov/revenue and require Adobe Acrobat Reader.

                                                       Interest, Penalties and Costs
        Effective January 1, 2014 - All taxes (except Real Estate) bear simple interest.  The annual rate shall be the Federal
        Short-Term Rate effective January 1 of such calendar year (26 § USCA 6621 et. seq.) plus five (5) percentage points.

        Penalty will be at the rate of 1¼% of the unpaid tax for each month or fraction thereof.

        For current interest rates, see the Department of Revenue's website at   www.phila.gov/revenue.

                                                                                                                             2020 Earnings Inst.   0-1 14-2020
                                                                      Instruction Sheet A



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                                   NON-RESIDENT EMPLOYEE EARNINGS ALLOCATION
             AND/OR DEDUCTIBLE EMPLOYEE BUSINESS EXPENSES REPORT INSTRUCTIONS

If Wage tax was overwithheld by your employer, do not file this return.  File the Employee Wage Tax Refund Petition.

Allocated Compensation:  A   nonresident of Philadelphia receiving compensation for services performed both in and
out of Philadelphia may allocate that compensation by completing Page 2 of the Annual Reconciliation of Earnings Tax
Return.

You must enclose copies of your W-2 forms containing Federal, Medicare, State and Local Wages.  If you worked a partial
year in Philadelphia, fill in the beginning and ending dates.  Page 2, Line 2A should only reflect the number of days/hours
employed.

Line 2B - Non-workdays/Hours:  During a period of sickness or disability, if you receive your regular salary, the salary is
considered to be taxable compensation.  If you receive worker's compensation or a plan in lieu of worker's compensation
where the amount received is less than your regular salary, the compensation   is not subject to Philadelphia Wage Tax.  
Non-workdays include Saturday, Sunday, vacation, holidays, leave, sick days, and any day you do not actually
work.  Include 104 days for Saturday and Sunday if you work a 5 day week.

Line 2C:    If computing overtime, fill in hours   and include overtime hours in Line 2A.

Line  2G/4E  -  Expenses:    Entries  on  Lines  2G  and  4E  must  be  supported  by  Federal  Form  2106.    If  unreimbursed
employee expenses are claimed on Federal Schedule A, you must also include Schedule A.  Photocopies are acceptable.
Expenses are deductible if the total expenses are reduced by any amounts reimbursed by your employer and they are
ordinary, necessary and reasonable.

Examples  of  expenses  which  are  not  deductible  are:    transportation  to  and  from  work,  certain  educational  expenses,
dues, subscriptions, and pension plan contributions.  You must be a   Statutory Employee as indicated on your W-2 form
to claim Federal Schedule C expenses.  Otherwise, you must obtain a Philadelphia Business Tax Account Number and
file Business Income & Receipts/Net Profits Tax returns.  If you are not a Statutory Employee and you want to claim
Federal Schedule C expenses, do not file the Earnings Tax Reconciliation return.  To obtain a Business Tax Account
Number application, refer to the contact information on Instruction Sheet A.

Line 5 - Total Non-taxable Gross Compensation:  Enter the total of Line 5 on Page 1, Line 2.

Line  6  -  Taxable  Gross  Compensation:    Residents  enter  Column  A  on  Page  1,  Line  4  or  Line  5  if  eligible  for
Income-based rate; Column B on Page 1, Line 7 or Line 8 if eligible for Income-based rate. Nonresidents enter
Column A on Page 1, Line 10 or Line 11 if eligible for Income-based rate; Column B on Page 1, Line 13 or Line 14
if eligible for Income-based rate.
                     Wage Taxes Paid or Payable to Other Jurisdictions Within Pennsylvania

Residents of Philadelphia are required to pay Philadelphia Wage Tax on all salaries, wages and compensation regardless
of  where  that  compensation  was  earned.    Philadelphia  residents  employed  in  other  localities  in  Pennsylvania  should
instruct their employers   not to withhold other local income taxes from their compensation.

Nonresidents  of  Philadelphia  residing  in  Pennsylvania  and  employed  within  the  City  of  Philadelphia  must  pay  the
Philadelphia Wage tax on all compensation earned in Philadelphia.  Nonresident compensation not subject to Philadelphia
Wage  Tax  (due  to  services  rendered  outside  of  Philadelphia)  may  be  subject  to  taxation  in  the  employee's  home
jurisdiction.
                     Wage Taxes Paid or Payable to Other Jurisdictions Outside Of Pennsylvania

Residents of Philadelphia whose wages are subject to the taxes of local jurisdictions outside of Pennslyvania, can take a
credit against the Earnings Tax due on line 17 of page 1 of the Earnings Tax Return. Include a copy of the W-2 showing the
tax paid to the other jurisdiction.

                                                      Reciprocal Agreements
                           (Employment in/or Residents of States other than Pennsylvania)

The City of Philadelphia is not a party to any reciprocal tax agreements with any other state or political subdivision thereof.   
Nonresidents of Pennsylvania cannot claim a tax credit against Philadelphia Wage Tax for income taxes paid to any other
state or political subdivision.  Residents of Philadelphia employed outside of Pennsylvania may be required to file and pay a
local income tax in that jurisdiction in addition to Philadelphia Wage Tax.
                                                                                                 2019 Earnings Inst.  10-1 202- 20
                                                        Instruction Sheet B



- 12 -
                           2020 Annual Reconciliation of Employee Earnings Tax 
                                    Form Barcode Number: 30120 
                                         Barcode Type: Code 3 of 9 
 Top Barcode X/Y Position:          38/4       Bottom Barcode X/Y Position:           56/64 
 Top Barcode Narrow Bar Width:      17 mils    Bottom Barcode Narrow Bar Width:       20 mils 
 Top Barcode Narrow to Width Ratio:  2.5       Bottom Barcode Narrow to Width Ratio:  3.0 

 Field                                      # of chars.            X/Y Start Position 
 
 Top Left Reg. Mark                                                7/5 
 Top Right Reg. Mark                                               80/5 
 Bottom Left Reg. Mark                                             7/64 
 Bottom Right Reg. Mark                                            80/64 
 
 Name & Address Line 1                      40                     8/10 to 47/10 
 Name & Address Line 2                      40                     8/11 to 47/11 
 Name & Address Line 3                      40                     8/12 to 47/12 
 Name & Address Line 4                      40                     8/13 to 47/13 
 Name & Address Line 5                      40                     8/14 to 47/14 
 
 Social Security Number                     9                      63/9   to 71/9 
 Termination Date                           10                     66/15 to 75/15 
 Amended Return Check Box                   1                      81/17 to 81/17 
 
 Line 1                                     7                      70/19 to 76/19 
 Line 2                                     7                      70/20 to 76/20 
 Line 3                                     7                      70/22 to 76/22 
 Line 4                                     7                      70/24 to 76/24 
 Line 5                                     7                      70/26 to 76/26 
 Line 6                                     7                      70/27 to 76/27 
 Line 7                                     7                      70/29 to 76/29 
 Line 8                                     7                      70/31 to 76/31 
 Line 9                                     7                      70/32 to 76/32 
 Line 10                                    7                      70/34 to 76/34 
 Line 11                                    7                      70/36 to 76/36 
 Line 12                                    7                      70/37 to 76/37 
 Line 13                                    7                      70/39 to 76/39 
 Line 14                                    7                      70/41 to 76/41 
 Line 15                                    7                      70/42 to 76/42 
 Line 16                                    7                      70/44 to 76/44 
 Line 17                                    7                      70/47 to 76/47 
 Line 18                                    7                      70/48 to 76/48 
 Line 19                                    7                      70/50 to 76/50 
 Line 20                                    7                      70/52 to 76/52 
 Line 21 A                                  7                      70/54 to 76/54 
 Line 21 B                                  7                      70/55 to 76/55 
 
                                            12 



- 13 -
                                                                                                                       2020 ERN
                                                           30120
     CITY OF PHILADELPHIA                                                                     DUE DATE: APRIL 15, 2021
ANNUAL RECONCILIATION OF   
2020 EMPLOYEE EARNINGS TAX                                                                         SOCIAL SECURITY NUMBER
                                                                                                                                              999999999
Name and address..................Line 1                                            DO  NOT  FILE  THIS  RETURN if     tax  was  100%  withheld  on  all
Name and address..................Line 2                                            compensation  by  your  employer.    If  tax  was  overwithheld  by  your
Name and address..................Line 3                                            employer,  file  the  Employee  Wage  Tax  Refund  Petition  available  at
                                                                                    www.phila.gov/revenue    in the forms and documents section.
Name and address..................Line 4
Name and address..................Line 5                                            Cancel this account by entering the termination date 
                                                                                    AND file a CHANGE FORM.
                                                                                                                                                          mm-dd-yyyy
YOU MUST USE THE CHANGE FORM TO REPORT A CHANGE OF ADDRESS.
IF YOU ARE NOT ELIGIBLE FOR PA 40 SCHEDULE SP, YOU ARE NOT ELIGIBLE FOR                       If this is an amended return place an "X" here:                       X
INCOME-BASED TAXATION AND CANNOT USE LINES 5, 8, 11, OR 14.
1. Gross Compensation received in 2020.  Enclose 2019 W-2 form(s)........................................................... 1.                           9999999
2. Non-taxable gross compensation from Page 2, Line 5................................................................................         2.          9999999

3. Gross taxable compensation (Line 1 minus Line 2).....................................................................................      3.          9999999
4. Taxable Gross Compensation received by a   resident of Philadelphia
 January 1, 2020 to June 30, 2020.............................................................................................................. 4.        9999999
5. Taxable Gross Compensation, eligible for Income-based Rate,
 received by a   resident of Philadelphia January 1, 2020 to June 30, 2020............................................                        5.          9999999
6. Tax Due (Line 4 times .038712   OR Line 5 times .033712 if claiming Income-based rate.)........................                            6.          9999999
7.  Taxable Gross Compensation received by a   resident of Philadelphia
 July 1, 2020 to December 31, 2020........................................................................................................... 7.          9999999
8.  Taxable Gross Compensation, eligible for Income-based Rate,
 received by a   resident of Philadelphia July 1, 2020 to December 31, 2020.........................................                          8.          9999999
9. Tax Due (Line 7 times .038712 OR Line 8 times .015000 if claiming Income-based rate).........................                              9.          9999999
10.  Taxable Gross Compensation received by a   nonresident of Philadelphia
  January 1, 2020 to June 30, 2020............................................................................................................. 10.       9999999
11.  Taxable Gross Compensation, eligible for Income-based Rate,
  received by a   nonresident of Philadelphia January 1, 2020 to June 30, 2020.................................... 11.                                    9999999
12. Tax Due (Line 10 times .034481   OR Line 11 times .029481 if claiming Income-based rate)....................                              12.         9999999
13.  Taxable Gross Compensation received by a   nonresident of Philadelphia
  July 1, 2020 to December 31, 2020.......................................................................................................... 13.         9999999
14.  Taxable Gross Compensation, eligible for Income-based Rate,
  received by a   nonresident of Philadelphia July 1, 2020 to December 31, 2020.................................. 14.                                     9999999
15. Tax Due (Line 13 times .035019   OR Line 14 times .015000 if claiming Income-based rate).................... 15.                                      9999999

16. Total amount of Tax Due (Add Lines 6, 9, 12 and 15)...............................................................................        16.         9999999
17. Philadelphia Wage Tax withheld by employer or credit for taxes paid to local jurisdictions
   outside of PA. Attach W-2. See Instructions
    If Line 17 is greater than Line 16 file an Employee Wage Tax Petition for this amount.................... 17.                                         9999999
18. Tax balance due.  (Line 16 minus Line 17.  Cannot be less than zero.).................................................... 18.                         9999999

19. Tax that   you,   not your employer, previously paid for 2020. (Not included on W-2 forms)......................... 19.                               9999999
20.  TAX DUE  If Line 18 is greater than Line 19,  enter here and in the Tax Due box
  of the Payment Coupon.............................................................................................................................. 20. 9999999
21a.  If Line 18 is less than Line 19, enter amount to be: 
 REFUNDED.   Do not file a separate Refund Petition. Enclose W-2 forms.........................................                        21a.               9999999
21b.  Amount of overpayment to be   APPLIED to the 2021 Earnings Tax Return...........................................                 21b.               9999999
     Under penalties of perjury, as set forth in 18 PA C.S. §§ 4902-4903 as amended, I swear that I have reviewed this return 
     and accompanying statements and schedules, and to the best of my knowledge and belief, they are true and complete.
Taxpayer Signature________________________________________  Date_______________________Phone #_________________________

Preparer Signature_________________________________________ Date_______________________Phone #_________________________

                                                                                                   Vendor Name & Sumbission Date
                                                           ERN Page 1



- 14 -
                                       NON-RESIDENT EMPLOYEE EARNINGS ALLOCATION
                                AND/OR DEDUCTIBLE EMPLOYEE BUSINESS EXPENSES REPORT

Residents and non-residents of Philadelphia must complete this report to calculate deductible employee business
expenses.  Certain non-residents must complete this report to calculate non-taxable compensation.    If wage tax was
overwithheld by your employer, do not file this return.  File the Employee Wage Tax Refund Petition.

EMPLOYER                                                                                                     EMPLOYEE SOCIAL SECURITY NUMBER

PLACE OF EMPLOYMENT                                                                                          IF PARTIAL YEAR, PROVIDE DATES:
                                                                                                             From                        To
                                                                                                             EMPLOYER IDENTIFICATION NUMBER (From Form W-2)

                                                                                                             Column A                             Column B
     Read Instruction Sheets A and B before completing this report.                                          1/1/2020 to    6/30/2020       7/1/2020 to 12/31/2020
1.   GROSS COMPENSATION FOR EMPLOYEES PAID ON A SALARY BASIS per FORM W-2                                                          .00                              .00

   A.  Non-Taxable Compensation (e.g. Stock Options) included in Line 1.  (Must reflect on W-2)                                    .00                              .00

   B.  Adjusted Gross Compensation  (Subtract Line 1A from Line 1)                                                                 .00                              .00
2.  Computation of taxable compensation and/or allowable expenses
A.  Number of Days/Hours  (Include overtime from Line 2C)                                                                   Days/Hours                     Days/Hours
   B.  Non-workdays/Hours  (Total of weekend, vacation, holiday, sick or any type of leave time)                            Days/Hours                     Days/Hours
   C.  Number of actual Workdays/Hours  (Base_______________Overtime_______________)
        (Line 2A minus Line 2B)                                                                                             Days/Hours                     Days/Hours

   D.  Number of actual Days/Hours worked outside of Philadelphia in Line 2C                                                Days/Hours                     Days/Hours
   E.  Percentage of time worked outside of Philadelphia  (Line 2D divided by Line 2C)                                                %                             %

   F.  Non-taxable gross compensation earned outside of Philadelphia  (Line 1B times Line 2E)                                      .00                              .00

G. (i)  Total non-reimbursed business expenses pursuant to Income Tax Regulations Section 204                                      .00                              .00
      (ii)  Multiply amount on Line 2G (i) by the percentage on Line 2E                                                            .00                              .00

      (iii)  Deductible non-reimbursed employee business expenses.  (Subtract Line 2G (ii) from Line 2G (i))                       .00                              .00

   H.  Non-taxable income and/or deductible employee business expenses  (Add Line 2F and Line 2G (iii))                            .00                              .00

3.   GROSS COMPENSATION FOR EMPLOYEES PAID ON A COMMISSION BASIS per FORM W-2                                                      .00                              .00

   A.  Non-Taxable Compensation (e.g. Stock Options) included in Line 3.  (Must reflect on W-2)                                    .00                              .00
   B.  Adjusted Gross Compensation  (Subtract Line 3A from Line 3)                                                                 .00                              .00
4.  Computation of taxable compensation and/or allowable expenses
A.  Total Sales                                                                                                                    .00                              .00

   B.  Sales earned outside of Philadelphia (Income Regulations 209(b))                                                            .00                              .00
   C.  Percentage of sales outside of Philadelphia.  (Divide Line 4B by Line 4A.)                                                     %                             %

   D.  Commissions earned outside of Philadelphia.  (Multiply Line 3B by 4C.)                                                      .00                              .00

E. (i)  Total non-reimbursed business expenses pursuant to Income Tax Regulations Section 204                                      .00                              .00

      (ii)  Multiply amount on Line 4E (i) by the percentage on Line 4C                                                            .00                              .00
      (iii)  Deductible non-reimbursed employee business expenses.  (Subtract Line 4E (ii) from Line 4E (i))                       .00                              .00
F.  Non-taxable gross commissions/deductible employee business expenses. (Add Line 4D and Line 4E (iii))                           .00                              .00

5.   TOTAL NON-TAXABLE GROSS COMPENSATION  (Add Lines 2H and Line 4F from Columns A   and B.)                                               .00
Enter here and on Line 2 of the return.
6.   TAXABLE GROSS COMPENSATION (Line 1B minus Line 2H   PLUS Line 3B minus Line 4F)
Residents enter Column A on Page 1, Line 4 or 5; Non-residents enter Column A on Page 1, Line 10 or 11.                            .00                              .00
Residents enter Column B on Page 1, Line 7 or 8; Non-residents enter Column B on Page 1, Line 13 or 14.

                                                                                                                                        2020 Earnings P2  09-15-2020
                                                                                  Page 2



- 15 -
             Philadelphia Scan Line Data 
 
         2020 Earnings Tax Reconciliation Coupon 
 
 Field #  Description 
 
 1 – 3    Always “333” 
 
 4 – 5    02 
          
 6 – 11   Due Date - 041521 
          
 12 – 19  Zero filled 
          
 20 – 28  Social Security Number Zero 
 
 29 – 49  filled 
 
 50 – 53  Period / Year - 0520 
          
 54 – 67  Zero filled 
          
 68       Check Digit (Reference Page 7) 

                          15 



- 16 -
                                       Detach here 
  ----------------------------------------------------------------------------------------------------------------------------------------------- 
         2020 Annual Reconciliation of                                         Due Date:  April 15, 2021 
         Employee Earnings Tax Payment Coupon 
 
  NAME:  Chip Kelly                                                            Tax Due   7777777                       .00 
  
  SOCIAL SECURITY #: 999999999                     Interest & Penalty                    7777777                       .00 

                                                                               Total Due 7777777                       .00 
 
                                Make check payable to:  "City of Philadelphia" 
                                Include the last 4 digits of your Social Security Number on your check or money order. 
 
         33302041521000000009999999990000000000000000000000520000000000000007 
 
                                       16 



- 17 -
               2020 ANNUAL RECONCILIATION OF EMPLOYER WAGE TAX 

Who Must File:          All employers who paid taxable compensation to residents of Philadelphia, even if earned 
                        outside of Philadelphia, and to non-residents for services performed within Philadelphia. 

When To File:           The Annual Reconciliation of Employer Wage Tax for the calendar year 2020 is due on or 
                        before March 1, 202                1. Failure to file and pay by this date will result in the imposition 
                        of interest, penalty, fines and legal costs. 

Where To File:          To file this return online, go to ework.phila.gov/revenue. After submitting the return, you 
                        must print the resulting confirmation page for your records. W2 data must be submitted in 
                        accordance with the requirements specified on Page 2 of these instructions.                                    To file this 
                        return by mail, sign the Annual Reconciliation return and mail to:  Philadelphia Department 
                        of Revenue, P.O. Box 1670, Philadelphia, PA 19105-1670. 
Print  your  numbers  legibly to  ensure  efficient  processing.  Photocopies  of this  return  are  not  acceptable.  Regulations,  returns  and  instructions  are 
available at www.phila.gov/revenue.  Contact the Department by calling 215-686-6600 or send e-mail to revenue@phila.gov. 

If  the  entity  no  longer  has  wage  tax  withholding  responsibilities,  use  the Change  Form to  indicate  the  termination  of  wage  tax  liability  and  enter  the 
termination date on the return in the space provided. The Change Form is available online at       www.phila.gov/tax-change. If the wage tax withholding 
responsibilities terminated prior to 2020, mail in the Change Form but do not complete and file a 2020 Wage Tax Reconciliation return. 
Line 3: Put on this line the amount of tip income reported to the employer by the tipped employees (e.g. IRS Form 4070) and any other tips allocated to 
the  employees  (by  the  employer)  in  accordance  with  applicable  U.S.  Treasury  Regulations. An  employer’s  liability  for  withholding  the  Wage  Tax  on 
employees’ tip income is based on the wages under the employer’s control (other than tips) and amounts turned over voluntarily to the employer by the 
employee to meet the withholding. Therefore, if the employer is unable (due to insufficient funds) to withhold the Wage Tax on any compensation (i.e. both 
salary and tips), report those amounts here. 
Line  13: Tax  Due  - If  the  tax  due  on  Line  13  of  the  Annual  Reconciliation  of  Wage  Tax  return  is  $1  or  more,  make  a  check  payable  to  "City  of 
Philadelphia". Do not remit tax due if less than $1. Internet filers can pay the tax due via credit card or by e-check. A user fee is added when paying by 
credit card. E-CHECK IS FREE. 
ACH Debits and Credits are accepted for payment of tax.  For more information or to enroll in this program go to www.phila.gov/revenue/eft-ach.  Contact 
the Electronic Government Unit at 215-686-6582, 6579 or 6628 or e-mail to egovservices@phila.gov. 
Returned Checks. If your check is returned unpaid for insufficient or uncollected funds, (1) you authorize The City of Philadelphia or its agent to make a 
one-time  electronic  funds  transfer  from  your  account  to  collect  a  fee  of  $20;  and  (2)  The  City  of  Philadelphia  or  its  agent  may re-present  your  check 
electronically to your depository institution for payment. 

Line 16: Tax Overpaid - To obtain a refund of an overpayment of Philadelphia City Wage Tax, you must file a Refund Petition with the Department of 
Revenue.  A refund can be the result of an over withholding of tax from the employees' pay by the employer or an overpayment of tax that was not withheld 
(a duplicate payment).  If the overpayment is the result of over withholding, a letter on company letterhead, signed by a company officer must accompany the 
Refund Petition stating that the tax that was over withheld has been refunded to the employee(s) by the company.  If the refund is the result of a duplicate 
payment, supporting documentation showing the duplicate payment must accompany your refund petition. 
To download a Refund Petition, go to www.phila.gov/documents/refund-petition-form. 

If you have questions about your filing requirements, application of payments or tax balances due, call Taxpayer Services at 
215-686-6600. 

                                                           Interest, Penalties and Costs 

        Effective January 1, 2014 - All taxes (except Real Estate) bear simple interest. The annual rate shall be the 
        Federal Short-Term Rate effective January 1 of such calendar year (26 § USCA 6621 et. seq.) plus five (5) 
        percentage points. 

        Penalty will be at the rate of 1¼% of the unpaid tax for each month or fraction thereof. 

        For current interest rates, see the Department of Revenue's website at www.phila.gov/revenue. 

                                                                                                                       2020 Wage  Inst. 09-29-2020 
                                                                      Page 1 



- 18 -
                                W2 Submission Requirements for 2020 

There are no format specification changes from 201 9to 20       20. 

Transmittal Form: The Annual Wage Tax Reconciliation return is the only form that is transmitted with the W2’s. 
No other transmittal form is required. 

Submitting  W2s:  Employers  with  more  than  250  W2’s  cannot  remit  on  paper. Employers with fewer than  250 
employees are strongly encouraged to remit electronic files and not use paper resources. 

To  submit  W2’s  electronically,  you  must  use  our  secure  FTP  site.  Find  instructions  and  access  to  the  FTP  site  at 
https://ework.phila.gov/revenue/. The City does not accept CDs or other electronic media through the mail. If  you  
file the  2020  Annual  Wage  Tax Reconciliation return online, you must still prepare an electronic W2 file and submit it 
via the City’s secure FTP site. 

Record Format for W2 electronic file:  Only the EFW2 (formerly MMREF-1) format is acceptable. This is the same 
format transmitted to the Social Security Administration, as stated in SSA Publication - Magnetic Media Reporting and 
Electronic Filing. PDF files are not acceptable. For full instructions, please refer to the Social Security Administration's 
instructions here: https://www.ssa.gov/employer/efw/19efw2.pdf. 

There are four record types required: submitter information (RA), employer information (RE), federal employee 
information (RW), and state employee information (RS). It is extremely important to follow exactly all Social 
Security Administration rules for displaying data. The following information for all four record types must be 
included: 

RA record: Submitter's Employer Identification Number (EIN), User Identification (User ID), Submitter Name, 
Submitter's Delivery Address, Submitter's City, Submitter's State Abbreviation, Submitter's ZIP Code, Contact Name, 
Contact Phone Number, Contact Email 
RE record: Tax Year, Employer/Agent Identification Number (EIN), Employer Name, Location Address, Delivery 
Address, City, State, Zip Code, Kind of Employer, Employer Contact Name, Employer Contact Phone Number, 
Employer Contact Phone Extension, Employer Contact Fax Number (If applicable enter the employers fax number 
including area code. Otherwise fill with blanks), Employer Contact E-Mail/Internet 
RW record: Social Security Number (SSN), Employee First Name, Employee Last Name, Wages, Tips & Other 
Compensation, Federal Income Tax Withheld, Social Security Wages, Social Security Tax Withheld, Medicare 
Wages and Tips, Medicare Tax Withheld, Social Security Tips, Dependent Care Benefits, Deferred Compensation 
Contributions to Section 401(k), Deferred Compensation Contributions to Section 403(b), Deferred Compensation 
Contributions to Section 408(k)(6), Deferred Compensation Contributions to Section 457(b), Deferred Compensation 
Contributions to Section 501(c)(18)(D), Nonqualified Plan Section 457 Distributions or Contributions, Nonqualified 
Plan Not Section 457 Distributions or Contributions, Deferral Under a Section 409A Nonqualified Deferred 
Compensation Plan 
RS record: If the employer is withholding Philadelphia Wage Tax on the employee, then the following fields are 
required (only include Philadelphia data - do not include data for other jurisdictions): 
Social Security Number (SSN), Employee First Name, Employee Last Name, Delivery Address, City, State 
Abbreviation, ZIP Code, State Taxable Wages, State Income Tax Withheld, Tax Type Code (must equal “C”), Local 
Taxable Wages (must equal Philadelphia Taxable Wages), Local Income Tax Withheld (must equal Philadelphia 
Wage Tax Withheld), State Control Number (must equal 7-digit City Tax Account number) 

File name specifications: When you upload the electronic W2 file to the City’s website, the file name must include 
the name of your company, the 7-digit City Tax Account number, and the tax year. 

Test Data: Philadelphia does not accept test data. If errors are found in your data file or if you have not used the 
required EFW2 format, you will be contacted. 

For inquiries concerning filing of W2’s, send an e-mail to revenue@phila.gov. 

                                                                                         2020 Wage   Inst. 09-29-2020 
                                                    Page 2 



- 19 -
                               2020 Annual Reconciliation of Employer Wage Tax 
                                    Form Barcode Number: 30220 
                                         Barcode Type: Code 3 of 9 
 Top Barcode X/Y Position:          38/4       Bottom Barcode X/Y Position:           56/64 
 Top Barcode Narrow Bar Width:      17 mils    Bottom Barcode Narrow Bar Width:       20 mils 
 Top Barcode Narrow to Width Ratio:  2.5       Bottom Barcode Narrow to Width Ratio:  3.0 
 
  Field                                     # of chars.            X/Y Start Position 
                                                         
  Top Left Reg. Mark                                               7/5 
  Top Right Reg. Mark                                              80/5 
  Bottom Left Reg. Mark                                            7/64 
  Bottom Right Reg. Mark                                           80/64 

  Name & Address Line 1                     40                     8/10 to 47/10 
  Name & Address Line 2                     40                     8/11 to 47/11 
  Name & Address Line 3                     40                     8/12 to 47/12 
  Name & Address Line 4                     40                     8/13 to 47/13 
  Name & Address Line 5                     40                     8/14 to 47/14 

  City Account Number                       7                      63/9   to 69/9 
  Federal Identification Number             9                      62/12 to 70/12 
  Termination Date                          10                     62/15 to 71/15 
  Amended Return Check Box                  1                      79/17 to 79/17 

  Line A                                    5                      75/19 to 79/19 
  Line B                                    5                      75/21 to 79/21 
  Line C                                    5                      75/23 to 79/23 
  Line D                                    5                      75/25 to 79/25 

  Line 1                                    9                      71/27 to 79/27 
  Line 2                                    9                      71/29 to 79/29 
  Line 3                                    9                      71/31 to 79/31 
  Line 4                                    9                      71/33 to 79/33 
  Line 5                                    9                      71/35 to 79/35 
  Line 6                                    9                      71/37 to 79/37 
  Line 7                                    9                      71/39 to 79/39 
  Line 8                                    9                      71/41 to 79/41 
  Line 9                                    9                      71/43 to 79/43 
  Line 10                                   9                      71/45 to 79/45 
  Line 11                                   9                      71/47 to 79/47 
  Line 12                                   9                      71/49 to 79/49 
  Line 13                                   9                      71/51 to 79/51 
  Line 14                                   9                      71/53 to 79/53 
  Line 15                                   7                      73/55 to 79/55 
  Line 16                                   7                      73/57 to 79/57 
 
                                            19 



- 20 -
                                                                                        20
              CITY OF PHILADELPHIA           30220                                                                                                20 WAG
                                                                                        DUE DATE:  MARCH 1, 202                                                        1
     ANNUAL RECONCILIATION OF 
     2020 EMPLOYER WAGE TAX                                                             City Account Number
                                                                                            9999999
Name and address..................Line 1
Name and address..................Line 2                                                Federal Identification Number
Name and address..................Line 3                                                    999999999
Name and address..................Line 4                                     If your business terminated in 2020, enter the 
Name and address..................Line 5                                     termination date   AND                                                 file a CHANGE FORM.
                                                                                            mm-dd-yyyy
YOU MUST USE THE CHANGE FORM TO REPORT A
CHANGE OF ADDRESS OR TO CANCEL THIS ACCOUNT.                                 If this is an amended return place an "X" here:                                            X
A.  Enter the number of Philadelphia Residents for whom wage tax was remitted for the pay period including 
 March 12, 2020.................................................................................................................................................... A. 99999
B.  Enter the number of   nonresidents (employees living outside Philadelphia city limits) for whom wage tax 
 was remitted for the pay period including March 12, 2020................................................................................... B.                        99999
C.  Total number of employees   for all company locations reported on the Employer's Federal Quarterly 
 Tax Return for the first quarter of 2020 (for the pay period including March 12, 2020).......................................  C.                                     99999
D.  Number of employees working   at company locations within Philadelphia city limits, 
     for the pay period including March 12, 2020........................................................................................................  D.           99999

1. Gross Compensation per W-2 forms for all employees.................................................................1.                                               999999999
2. Non-Taxable Gross Compensation included in Line 1.
   (Paid to nonresidents working outside of Philadelphia).................................................................2.                                           999999999
3. Taxable income paid to employees earning tips on which City Wage Tax
   was not withheld............................................................................................................................3.                      999999999
4. Gross Compensation per W-2 forms on which Philadelphia Wage Tax was
     withheld or due (Line 1 minus [Line 2 plus Line 3]).......................................................................4.                                      999999999
5.  Taxable Gross Compensation paid to   residents of Philadelphia
    January 1, 2020 to June 30, 2020...............................................................................................5.                                  999999999

6. Tax Due (Line 5 times .038712)....................................................................................................6.                                999999999
7.  Taxable Gross Compensation paid to   residents of Philadelphia
    July 1, 2020 to December 31,2020.............................................................................................7.                                    999999999

8. Tax Due (Line 7 times .038712)....................................................................................................8.                                999999999
9.  Taxable Gross Compensation paid to   nonresidents of Philadelphia
    January 1, 2020 to June 30, 2020...............................................................................................9.                                  999999999

10. Tax Due (Line 9 times .034481)...................................................................................................10.                               999999999
11.  Taxable Gross Compensation paid to   nonresidents of Philadelphia
       July 1, 2020 to December 31, 2020...........................................................................................11.                                 999999999

12. Tax Due (Line 11 times .035019)................................................................................................12.                                 999999999

13.  Total Tax Due   (Add Lines 6, 8, 10 and 12).................................................................................13.                                   999999999

14.  Tax previously paid for 2020.....................................................................................................14.                              999999999

15.  ADDITIONAL TAX DUE  If Line 13 is greater than Line 14, enter the amount here...................15.                                                               9999999
16.  TAX OVERPAID  If Line 14 is greater than Line 13, enter the amount here.
  See instructions............................................................................................................................16.                      9999999
     Under penalties of perjury, as set forth in 18 PA C.S. §§ 4902-4903 as amended, I swear that I have reviewed this return and
     accompanying statements and schedules, and to the best of my knowledge and belief, they are true and complete.
     Taxpayer Signature________________________________________  Date__________________Phone #____________________
     Preparer Signature_________________________________________ Date__________________Phone #____________________
                                                                                        Vendor Name & Sumbission Date 
                                                         WAG Page 1



- 21 -
                    Philadelphia Scan Line Data 
 
         2020 Annual Wage Tax Reconciliation Coupon 
 
 Field #          Description 
 
 1 – 3            Always “333” 
 
 4 – 5            Type Tax -  01
               
 6 – 11           Due Date - 030121 
 
 12 – 19          Zero filled 
 
 20 – 26          Business Tax Account Number 
 
 27 – 49          Zero filled 
 
 50 – 53          Period / Year – see below 
 
 54 – 67          Zero filled 
 
 68               Check Digit (Reference Page 7) 
 
 Frequency        Period/year for scan line 
 
 Weekly filers         5320 

 Monthly Filers        9120 

 Semi-monthly filers   7820 

 Quarterly filers      9620 

                              21 



- 22 -
                                    Detach here 
  ----------------------------------------------------------------------------------------------------------------------------------------------- 
         2020 ANNUAL RECONCILIATION                                        Due Date:  March 1, 2021 

         OF WAGE TAX PAYMENT COUPON 
  NAME:  Quincy J. Taxpayer                                                Tax Due    7777777       .00 
  
  CITY AC  COUNT #: 9999999                     Interest & Penalty                    7777777       .00 
         
                                                                           Total Due  7777777       .00 
 
                            Make check payable to:  "City of Philadelphia" 
                            Include your Account Number on your check or money order. 
 
         33301030121000000009999999000000000000000000000005320000000000000008 
 
                                    22 



- 23 -
                                 2020 School Income Tax Return General Filing Information

The School District of Philadelphia imposes a tax on different classes of net income.  Examples of taxable income are dividends, certain interest, certain
rents, and royalties.  All residents of Philadelphia who receive these types of income must pay the tax.
Who should file - Only Philadelphia residents with taxable income.  Review the instructions on Page 2 for a list of taxable income.
Interest on bank savings accounts, checking accounts and certificates of deposit issued by banks is not taxable.
If you were a resident of Philadelphia for only a portion of 2020, indicate your period of residency in the space provided on the return.  Certain taxable income 
should be pro-rated based on your period of residency.  Fox example, if you owned a stock for the entire year and received a dividend of $1,000, but moved 
to Philadelphia on July 1, 2020, only $500 of the dividend would be taxable.  If this was your only taxable dividend, you would enter $500 on Line 1 of the  tax 
return.
If income was realized on a specific date, your residency on that date will determine its taxability.  In the above example, if you had a short-term capital gain 
(held six months or less) that was realized on June 1, 2020, none of that gain is taxable since you were not a Philadelphia resident on that date.  For further                
information, contact the Technical Staff at   revenuetaxadvisors@phila.gov.
Filing status - A husband and wife may file a combined return.  However, losses from one spouse cannot be offset against gains from the other spouse.
Social Security Numbers - This return contains provisions for Social Security numbers.  If these spaces are blank, complete them.  Disclosure of Social
Security numbers is required pursuant to the provisions of Title 19 of the Philadelphia Code and regulations promulgated thereto.  Social Security numbers
are used to identify taxpayers and to ensure compliance of all City tax laws.  Social Security numbers are treated as confidential, except in the course of
Department of Revenue official business.
Change Form - If the preprinted information listed on the return is incorrect, use a Change Form to make the necessary corrections.  Find a Change Form at
www.phila.gov/tax-change.    For  example,  if  your  spouse  is  deceased  but  the  preprinted  information  pertains  to  your  spouse,  use  a  Change  Form  to
indicate your name and Social Security number.
When to file - This return is due on or before April 15, 2021.    Failure to file and pay by this date will result in the imposition of interest and penalty.
Internet Filing - Sign the return and mail to:  Philadelphia Department of Revenue, P.O. Box 389, Philadelphia, PA   19105-0389.
Where to File  - To file this return online, go to  ework.phila.gov/revenue.   After submitting the return you must print the resulting confirmation page     
for your records.
Payment of tax - If the tax due on Line 14 of the School Income Tax return is $1 or more, make a check payable to "City of Philadelphia".  Do not remit tax 
due if less than $1.  Internet filers can pay the tax due via debit card, credit card or e-check.  A user fee is added of 2.25% when paying by credit card  and 
3.95 %when paying by debit card. Paying by E-Check is        FREE.
In Person Payments - Payments can be made in person in the Concourse           area of the Municipal Services Building (1401 John F. Kennedy Blvd.), but you 
may need an appointment first. Visit www.phila.gov/revenue for our latest COVID-19 guidance.
ACH Debits and Credits are accepted for payment of tax.  For more information or to enroll in this program go to   www.phila.gov/tax-change.  Contact the
Electronic Government Unit at 215-686-6582, 6579 or 6628 or e-mail to   egovservices@phila.gov.

Returned Checks. If your check is returned unpaid for insufficient or uncollected funds, (1) you authorize The City of Philadelphia or its agent to make a
one-time  electronic  funds  transfer  from  your  account  to  collect  a  fee  of  $20;  and  (2)  The  City  of  Philadelphia  or  its  agent  may  re-present  your  check
electronically to your depository institution for payment.
Termination of School Income Tax filing responsibility - If you no longer have income subject to School Income Tax, use a Change Form to indicate the 
termination of School Income Tax filing responsibility.  If the School Income Tax filing responsibility terminated prior to 2020, mail a Change Form indicating 
the date of termination but   do not complete and mail the 2020 School Income Tax return.  Find a Change Form at   www.phila.gov/tax-change.
Contact  information:    Send  e-mail  to   revenue@phila.gov  or  call   215-686-6600.    Additional  returns  and  the  Change  Form  can  be  downloaded  from
www.phila.gov/revenue in the "Tax Forms & Instructions" section and require Adobe Acrobat Reader.

                                                             Interest, Penalties and Costs

             Effective January 1, 2014 - All taxes (except Real Estate) bear simple interest.  The annual rate shall be the
             Federal Short-Term Rate effective January 1 of such calendar year (26 § USCA 6621 et. seq.) plus five (5)
             percentage points.

             Penalty will be at the rate of 1¼% of the unpaid tax for each month or fraction thereof.

             For current interest rates, see the Department of Revenue's website at   www.phila.gov/revenue                         .

                                                                                                                                  2020 SIT Inst.  10-08-2020
                                                                            Page 1



- 24 -
           INSTRUCTIONS FOR PREPARING THE SCHOOL INCOME TAX RETURN
Read  these  instructions  carefully  to  determine  if  you  have  income subject  to  the  tax.   Income from Federal
Schedule "C" business income and W-2 income should not be reported on the School Income Tax return.

Beginning with tax year 2016, proceeds from the Pennsylvania Lottery are now taxable.
Any net losses on Lines 1 through 8 of the return should be entered as "0".  Losses may not be used to offset other types of income.
Print your numbers legibly and boldly within the spaces provided to ensure efficient and accurate processing of your return.  Photocopies of
this return are not acceptable.
Line 1.    All dividends are taxable unless they are a return of capital on a life insurance policy, from common stock of a National Bank, or from United
States government obligations.    All other dividends are taxable regardless of the source.  You cannot reduce this income by reinvested dividends.
Line 2.  Interest income on the Federal or State tax return may be included.  Examples of taxable interest include, but are not limited to:  interest income
from securities, mortgages, private loans, insurance policies, bank notes, repurchase agreements, Fannie and Ginnie Mae obligations, and other sources.
The following are examples of   non-taxable interest income:
           A.  Direct obligations of the Federal Government
           B.  Bonds or debt obligations of Pennsylvania or its political subdivisions
           C.  Interest on savings, checking, escrow and money market savings accounts that are deposited in:
                               1. Private Banks                              4. Credit Unions
                               2. Building and Loan Associations             5. Savings Banks
                               3. Savings and Loan Associations              6. Bank and Trust Company or Trust Companies
Line 3.  The distribution of income from a "Subchapter S" Corporation.  For more information see Worksheet "S" on   www.phila.gov/revenue.
Line 4.  The pro rata share of any limited partnership income not otherwise subject to Philadelphia Net Profits Tax is taxable.  If this is a net loss, enter
"0".
Line 5.  Income from estates and trusts is taxable only if it is received by or credited to the beneficiary and is the type of income that would normally be
subject to this tax.    For example, if the income from a trust consists of interest and dividends, the amount taxable would be determined as in
Lines 1 and 2 above.
Line 6.  Net gains and losses are taxable from the sale of tangible and intangible personal property and real property held for six months or less.    Note:  
This holding period differs from the 12 months or less period used by the Federal Government to identify short term capital gains.  If this is a net
gain, enter the gain on Line 6.  If this is a net loss, enter "0".
Line 7.  Net rental income received from the ownership of real or personal property is taxable unless the income is subject to Philadelphia Business
Income & Receipts and/or Net Profits taxes.  If this is a net loss, enter "0".  For School Income Tax purposes, report the net rental activity from a property
which meets all of the following three criteria:
           1. It is the principal residence of the owner;
           2. It is totally residential;
           3. It consists of 3 rental units or less.
If the activity does not meet these criteria, you must file Business Income & Receipts and/or Net Profits taxes.

Owners of properties with 4 or more rental units must file the Business Income & Receipts and/or Net Profits tax returns.  Rental units do not
include the unit occupied by the owner.  (See BIRT Regulations Section 101 D. 8.).
Line 8.  Report the following income:  1) royalty or copyright, 2) an award of punitive damages, 3) the monetary value of any prize or award, 4)
income from any annuity under a policy of insurance unless payable from a contract of employment as a part of retirement or pension plan, and
5) net proceeds from gambling (including Pennsylvania Lottery Cash Prizes).  If this is a net loss, enter "0".
Line 9.  Add Lines 1 through 8.
Line 10.  You may include all reasonable expenses directly incurred in the production of taxable income if they were paid solely for the
production of that income.  Examples of allowable expenses are:  1) safe deposit box rentals, 2) margin account interest, and 3) any fee paid in
2018 for the preparation of the School Income Tax return.
Line 11.  Subtract Line 10 from Line 9.
Line 12.  Gross Tax Due.  Multiply Line 11 by 3 8. 712%.
Line 13.  Enter here any credits from prior years and/or tax previously paid.
Line 14.  TAX DUE.  If Line 12 is greater than Line 13, enter the tax due on Line 14 and in the "Tax Due" box of the payment coupon. 
Line 15A.  If Line 13 is greater than Line 12, enter the amount of tax overpaid to be   REFUNDED.

                                                                  OR
Line 15B.  If Line 13 is greater than Line 12, enter the amount of tax overpaid to be APPLIED to the 2021 School Income Tax.
                                  For more on filing the School Income Tax Return go to   bit.ly/sitvideo.

                                                                                                                    2020 SIT Inst.      10-08-2020
                                                                    Page 2



- 25 -
                                         2020 School Income Tax 
                                    Form Barcode Number: 30320 
                                         Barcode Type: Code 3 of 9 
 Top Barcode X/Y Position:          38/4       Bottom Barcode X/Y Position:           56/64 
 Top Barcode Narrow Bar Width:      17 mils    Bottom Barcode Narrow Bar Width:       20 mils 
 Top Barcode Narrow to Width Ratio:  2.5       Bottom Barcode Narrow to Width Ratio:  3.0 
 
  Field                                     # of chars.            X/Y Start Position 
                                                         
  Top Left Reg. Mark                                               7/5 
  Top Right Reg. Mark                                              80/5 
  Bottom Left Reg. Mark                                            7/62 
  Bottom Right Reg. Mark                                           80/62 

  Name & Address Line 1                     40                     8/9   to 47/9 
  Name & Address Line 2                     40                     8/10 to 47/10 
  Name & Address Line 3                     40                     8/11 to 47/11 
  Name & Address Line 4                     40                     8/12 to 47/12 
  Name & Address Line 5                     40                     8/13 to 47/13 

  Social Security Number                    9                      61/9   to 69/9 
  Spouse's SS#                              9                      61/12 to 69/12 
  Amended Return Check Box                  1                      80/14 to 80/14 
  Partial Resident Date 1                   10                     56/16 to 65/16 
  Partial Resident Date 2                   10                     69/16 to 78/16 
  Termination Date                          10                     71/17 to 80/17 

  Line 1                                    7                      71/19 to 77/19 
  Line 2                                    7                      71/21 to 77/21 
  Line 3                                    7                      71/23 to 77/23 
  Line 4                                    7                      71/25 to 77/25 
  Line 5                                    7                      71/27 to 77/27 
  Line 6                                    7                      71/29 to 77/29 
  Line 7                                    7                      71/31 to 77/31 
  Line 8                                    7                      71/33 to 77/33 
  Line 9                                    7                      71/35 to 77/35 
  Line 10                                   7                      71/37 to 77/37 
  Line 11                                   7                      71/39 to 77/39 
  Line 12                                   7                      71/41 to 77/41 
  Line 13                                   7                      71/43 to 77/43 
  Line 14                                   7                      71/45 to 77/45 
  Line 15 A                                 7                      71/48 to 77/48 
  Line 15 B                                 7                      71/50 to 77/50 
 
                                            25 



- 26 -
                                                                                                              2020 SIT
                                                      30320
                 CITY OF PHILADELPHIA                                                         DUE DATE:  APRIL 15, 2021 

          2020 SCHOOL INCOME TAX                                                              Your Social Security Number
Name and address..................Line 1                                                             999999999
Name and address..................Line 2
Name and address..................Line 3                                                    Spouse's Social Security Number
Name and address..................Line 4                                                             999999999
Name and address..................Line 5
DO NOT REPORT NEGATIVE NUMBERS ON THIS RETURN                                   If this is an amended return place an "X" here:                     X
YOU MUST USE THE CHANGE FORM TO REPORT A CHANGE OF ADDRESS.
If you were a partial year resident in 2020, see instructions and enter dates of residency: mm-dd-yyyy to                                 mm-dd-yyyy
If you no longer have income subject to School Income Tax enter the termination date   AND    file a CHANGE FORM:                         mm-dd-yyyy

   1. Net Taxable Dividends (School Income Tax Regulation 203(a))...............................................1.                        9999999

   2. Taxable Interest (Reg. 203(b))...................................................................................................2. 9999999

   3. "Subchapter S" Corporation Income Distribution (Regs. 202 and 203)......................................3.                          9999999

   4. Limited Partnership Income (Reg. 203(i)).  If loss, enter "0" (zero)............................................4.                  9999999

   5. Taxable Income received by a Beneficiary of an Estate or Trust (Reg. 205).............................5.                            9999999

   6. Net Short Term Capital Gains   (held 6 months or less)    If loss, enter "0" (zero)......................6.                         9999999

   7. Net Rental Income (Reg. 203(c)).  If loss, enter "0" (zero).........................................................7.              9999999

   8. Other Taxable Income (Reg. 203(e, f, g and h)).........................................................................8.           9999999

   9. Total Taxable Income (Add lines 1 through 8)............................................................................9.          9999999

   10. Deductible Expenses   (cannot exceed Line 9)   (Reg. 204(a))..................................................10.                  9999999

   11. Net Taxable Income (Subtract line 10 from line 9)....................................................................11.           9999999

   12. Gross Tax Due (Multiply line 11 by .038712)............................................................................12.         9999999

   13. Credit from overpayment of prior year or tax previously paid by extension..............................13.                         9999999

   14.  TAX DUE  If Line 12 is greater than Line 13, enter the difference here ...................................14.                     9999999

OVERPAYMENT OPTIONS  If Line 12 is less than Line 13, enter the amount to be:
   15A.  Refunded.  Do not file a separate Refund Petition...........................................................15A.                 9999999

   15B.  Applied to the 2021 School Income Tax............................................................................... 15B.        9999999

          Under penalties of perjury, as set forth in 18 PA C.S. §§ 4902-4903 as amended, I swear that I have reviewed this return
          and accompanying statements and schedules, and to the best of my knowledge and belief, they are true and complete.

Taxpayer Signature________________________________________  Date_______________________Phone #_________________________

Spouse's Signature________________________________________ Date_______________________Phone #_________________________

Preparer Signature_________________________________________ Date_______________________Phone #_________________________

   Sign the return and mail to:  Philadelphia Department of Revenue, P.O. Box 389, Philadelphia, PA 19105-0389

                                                                                                   Vendor Name & Sumbission Date 
                                                          SIT Page 1



- 27 -
                                                                        2020 School Income Tax 
                                                                            S Corporation Shareholder 
                                                                 Worksheet to Calculate Regulatory Exclusion 

To be used by S Corporation Shareholders who reported their pro-rata share of S Corporation net income on their 
                       2007 through 2013 School Income Tax Returns. 

Taxpayer Name                                                                         Social Security Number 

S Corporation Name                                                                    Employer ID Number 

Calculation of Regulatory Exclusion for 2020 Net Taxable Distributions 

Line 1. Distributions from AAA (from 2020 Federal 1120S Schedule K-1 - Line 16D) 
Line 2. Pro rata S Corporation Income from 2020 Federal 1120S (If a loss enter zero). 
Line 3. Difference (Line 1- Line 2) 
* If Excess Distributions (Line 3 greater than 0) go to Line 4 to calculate the exclusion that can be taken.
**If Line 3 is less than or equal to 0 (i.e. negative number), report the distributions from Line 1 on Line 3 of the 2019 School 
Income Tax return and do not complete the rest of this Worksheet. 

Line 4. Exclusion Base Available (Total from, Line 7 of the 201 9Worksheet) 
Line 5. 2019 Exclusion Allowed (Lower of Line 3 or Line 4) 
Line 6. Net Taxable Distributions (Line 1 - Line 5) 
***Report the Net Taxable Distributions from Line 6 on the 2019 School Income Tax return Line 3. 

Line 7. Remaining Exclusion Base for 2021 SIT (Line 4 - Line 5) 

Under the penalties of perjury, as set forth in 18 PA C.C. §§ 4902-4903 as amended, I swear that I have reviewed this worksheet and to the best 
of my knowledge and belief, they are true and complete. 

Taxpayer Signature :                                             Date:                Phone No. 

Spouse's Signature :                                             Date:                Phone No. 

Preparer Signature :                                             Date:                Phone No. 

                                                                                                            2020 SIT Worksheet  11-06-2020 



- 28 -
        Philadelphia Scan Line Data 

      2020 School Income Tax Payment and Extension Coupons 

Field # Description 

1 – 3   Always “333” 

4 – 5   Type Tax -  29

6 – 11  Due Date - 041521 

12 – 18 Zero filled 

19 – 27 Social Security Number 

28 – 48 Zero filled 

49 - 52 Period / Year - 1220 

53 – 67 Zero filled 

68      Check Digit (Reference Page 7) 

                    28 



- 29 -
                   SCHOOL INCOME TAX EXTENSION WORKSHEET 

An automatic extension of time for filing the 2020 School Income Tax will be granted for 60 days by filing an extension 
payment coupon and paying 100% of the estimated tax due. If an extension of time to file has been obtained from the 
Internal  Revenue  Service  for  filing  your  individual  tax  return,  the corresponding  School  Income Tax  return  is  due  on  or 
before the due date of the federal extension. You will not receive a written confirmation of your extension request. Filing the 
extension payment coupon does not extend the time to pay the tax. Interest and penalty shall be added to the amount of tax 
not paid by the statutory due date. 

1. Total Tax (100% of estimated tax due)...................................................................         7777777 .00 

2. Other payments and/or credits you expect to report on Line 13.............................                       7777777 .00 

3. Tax balance due (Line 1 minus Line 2)
Enter here and on the extension payment coupon.................................................                     7777777 .00 

                   If Line 2 is greater than Line 1, do not file the extension coupon. 
-------------------------------------------------------------------------------------------------------------------------------------------- 
      2020 SCHOOL INCOME TAX                                                       Due Date:  April 15, 2021
      PAYMENT COUPON 

NAME: FRODO BAGGINS                                                                                         Tax Due 7777777 .00 

SOCIAL SECURITY #: 999999999                         Interest & Penalty                                             7777777 .00 

                                                                                                Total Due           7777777 .00 

                                    Make check payable to:  "City of Philadelphia" 
                                    Include the last 4 digits of your Social Security Number on your check or money order. 

      33329041521000000099999999900000000000000000000012200000000000000002 

-------------------------------------------------------------------------------------------------------------------------------------------- 
      2020 SCHOOL INCOME TAX                                                       Due Date:  April 15, 2021
      EXTENSION PAYMENT COUPON 

NAME: THORIN OAKENSHIELD 

SOCIAL SECURITY #: 999999999 
                                                  Extension Payment 
                                                  (From Line 3 of the worksheet.)                                   7777777 .00 

                                    Make check payable to:  "City of Philadelphia" 
                                    Include the last 4 digits of your Social Security Number on your check or money order. 

      33329041521000000099999999900000000000000000000012200000000000000002 

                                                  29 



- 30 -
     2020 Business Income & Receipts and Net Profits Taxes General Information
                            Tax regulations and forms are available at www.phila.gov/revenue.
       New for 2020! Do you have less than or equal to $100,000.00 in Philadelphia taxable gross receipts? If yes, you 
       are not required to file the BIRT return. Instead, go to         ework.phila.gov/revenue to file an NTL, you will need your 
       account number and a pin number to complete. You may still be liable for the NPT return.

When and Where to File - The 2020 Business Income and Receipts and Net Profits taxes are due by April 15, 2021.  A 
return must be filed even if an overall loss is incurred.   Failure to file a return by the due date could result in the imposition 
of fines, legal costs and non-filer penalties.  You can file and pay taxes on our website at       www.phila.gov/revenue/tax-
forms  . Payments can be made using e-check, credit card, or debit card.       E-CHECK IS FREE.  Do not enclose payments 
with your tax return.  Paper returns and payment coupons are also available.

Important Mailing Information!  If requesting a refund on either the BIRT or NPT return, both returns   must be mailed together to
P.O. Box 1137 to receive proper credit and to enable prompt processing of your refund request.  If both returns are not mailed together
your refund request may be denied.

Mail payments to:                  Mail returns requesting a refund to:     Mail returns not requesting a refund to:
City of Philadelphia               City of Philadelphia                        City of Philadelphia
Department of Revenue              Department of Revenue                       Department of Revenue
P.O. Box 1393                      P.O. Box 1137                               P.O. Box 1660
Philadelphia, PA 19105-1393              Phil adelphia, PA 19105-1137          Philadelphia, PA 19105-1660

Effective January 1st, 2018 any Business Income and Receipts or Net Profits Tax due April 17, 2018 and later
where the tax due on the return is $5,000.00 or greater is now required to be paid electronically. To file and pay go
to   www.phila.gov/revenue. A user fee is added when paying by credit card.    E-CHECK IS FREE.

ACH  Debits  and  Credits  are  accepted  for  payment  of  tax.    For  more  information  or  to  enroll  in  this  program  go  to 
www.   phila.gov/revenue/eft-ach.  Contact  the  Electronic  Government  Unit  at  215-686-6582,  6579  or  6628  or  e-mail 
egovservices@phila.gov. 

Returned Checks. If your check is returned unpaid for insufficient or uncollected funds, (1) you authorize The City of
Philadelphia or its agent to make a one-time electronic funds transfer from your account to collect a fee of $20; and (2)
The City of Philadelphia or its agent may re-present your check electronically to your depository institution for payment.

Change  Form  -  If  your  business  terminated,  changed  organization  or  entity,  complete  a  Change  Form  found  at 
www.phila.gov/revenue/tax-change.    If  you  maintain  a  Commercial  Activity  license  but  did  not  actively  engage  in 
business during 2020, complete a Change Form to indicate that you are not in business.            Do not file the 2020 Business 
Income and Receipts and/or Net Profits tax returns           .  If you begin a business again with the same Federal Identification 
or Social Security number you should reinstate your Philadelphia tax account number.  If there was a change of business 
entity (e.g., individual proprietorship to corporation),   you need a new Philadelphia Tax Account Number and commercial 
activity license.  Register online for a tax account number at          www.phila.gov/revenue .   

To report a change of address, check the box on Page 1 of the return and file a Change Form.

Neatly print or type all information.  Do not staple, fold or submit photocopies of the tax return. Do not submit
copies of Federal Returns.  File only required schedules.

2021 ESTIMATE INSTRUCTIONS

All  businesses  that  have  been  approved  as  a  New  Business  (Jump  Start)  as  defined  under  Philadelphia  Code 
19-3800 and has subsequently met or will meet the employment requirements, use Worksheet N to complete the Business 
Income & Receipts and Net Profit Tax returns. (You must complete a paper return if participating in Jump Start Philly).

All other New Businesses starting their business in Philadelphia during 2020 that do not qualify for Jump Start 
can pay the actual tax (Line 3) for 2020 by April 15, 2021. No 2021 estimate payment is required. 

For all other businesses which began conducting business in Philadelphia prior to 2020, a mandatory estimate tax 
payment  toward  the  2021  Business  Income  &  Receipts  tax  is  required  for  all  business  operating  in  Philadelphia.  This 
estimate is equal to 100% of the 2020 tax liability, on Line 3, prior to the application of any tax credits from Line 6b. Enter 
the amount of Line 3 on Line 4 of the return. If you enter an amount on Line 4 less than the amount on Line 3, you may be 
billed additional interest and penalty.

                                                                    Page 1                              2020 BIRT-NPT Info 09-25-2020



- 31 -
                                                 2020 Business Income and Receipts Tax

If all business is conducted and/or located within Philadelphia, only the BIRT-EZ Pages 1 and 2 should be completed and filed.
If business is conducted and/or located both in and out of Philadelphia, only Page 1 of the BIRT return and the appropriate combination of Schedules A
through E should be completed and filed.
Taxpayers must use the same method (Schedule A, Method I or Schedule B, Method II) that they elected on the first Business Income and Receipts Tax
return filed.  Only Schedule A (Form 24715) or Schedule B (Form 24415) should be completed and filed.
You must complete Schedule C-1 (Form 24515) if you are apportioning your income.  Failure to include this schedule with the return may result in the 
disallowance of your apportionment and you may be billed.  If Line 3 of Schedule C-1 is equal to 100%, the BIRT-EZ return must be filed instead.  An 
exception to the required use of the BIRT-EZ return (for a taxpayer whose business activity is 100% within the City of Philadelphia) is in the case of a 
manufacturer, wholesaler and/or retailer reporting the receipts base tax using the Alternate Receipts Tax Computation.  The Alternative Receipts Tax 
Computation is calculated on BIRT Schedule E which would require the taxpayer to use 2020 BIRT (i.e. long form) with Schedule C-1 calculated to 100%. 
Schedule C-1 should not be completed or filed if the BIRT-EZ return is filed.

If your business started in 2020 and has been approved as a New Business as defined under Philadelphia Code 19-3800 and has subsequently 
met  or  will  meet  the  employment  requirements,  then  use  Worksheet  N  to  complete  the  Business  Income  and  Receipts  and  Net  Profits  tax 
returns.  Worksheet N can be downloaded from  www.phila.gov/revenue in the "Tax Returns" section.

                                                      2020 Net Profits Tax

Every individual residing in Philadelphia during 2020 and operating a business or other activity inside or outside of Philadelphia and non- 
residents of Philadelphia, if engaged in such activities within Philadelphia, are subject to the Net Profits Tax.     Corporations are not subject to 
the Net Profits Tax.

Every partnership, limited partnership, limited liability company filing with the IRS as a partnership, association, or other group of two or more persons
operating a business within Philadelphia, whether residents or non-residents of Philadelphia, is subject to the Net Profits Tax.  A partnership comprised
solely of corporate partners must file a Net Profits Tax return even if no tax liability exists.  The City of Philadelphia follows the Federal tax treatment for
LLCs.  If the LLC chose corporate tax treatment, it would not be liable for Net Profits Tax.  If the LLC chose to be treated as a partnership or as a
disregarded entity, treated for federal filing purposes as an individual, it would be liable for Net Profits Tax.
Every estate or trust is subject to the Net Profits Tax if the estate or trust is engaged in any business which is subject to the Net Profits Tax per Income
Regulation 220(A)(3).

                                                 Interest, Penalties and Costs

      Effective January 1, 2014 - All taxes (except Real Estate) bear simple interest.  The annual rate shall be the
      Federal Short-Term Rate effective January 1 of such calendar year (26 § USCA 6621 et. seq.) plus five (5)
      percentage points.

      Penalty will be at the rate of 1¼% of the unpaid tax for each month or fraction thereof.

      For current interest rates, see the Department of Revenue's website at   www.phila.gov/revenue                          .

                                                                                                                      2020 BIRT-NPT Info 09-15-2020
                                                          Page 2



- 32 -
                               2020 Business Income & Receipts Tax - Page 1 
                                    Form Barcode Number: 30420 
                                         Barcode Type: Code 3 of 9 
 Top Barcode X/Y Position:          38/4       Bottom Barcode X/Y Position:           56/64 
 Top Barcode Narrow Bar Width:      17 mils    Bottom Barcode Narrow Bar Width:       20 mils 
 Top Barcode Narrow to Width Ratio:  2.5       Bottom Barcode Narrow to Width Ratio:  3.0 

 Field                                      # of chars.            X/Y Start Position 
 
 Top Left Reg. Mark                                                7/5 
 Top Right Reg. Mark                                               80/5 
 Bottom Left Reg. Mark                                             7/64 
 Bottom Right Reg. Mark                                            80/64 
 
 Name & Address Line 1                      40                     8/11   to 47/11 
 Name & Address Line 2                      40                     8/12   to 47/12 
 Name & Address Line 3                      40                     8/13   to 47/13 
 Name & Address Line 4                      40                     8/14   to 47/14 
 Name & Address Line 5                      40                     8/15   to 47/15 
 E-mail Address                             30                     51/16 to 80/16 
 Change of Address Box                      1                      45/17 to 45/17 
 
 City Account Number                        7                      68/9   to 74/9 
 Federal Identification Number              9                      67/11 to 75/11 
 Social Security Number                     9                      67/13 to 75/13 
 
 Termination Date                           10                     60/19 to 69/19 
 Amended Return Check Box                   1                      80/21 to 80/21 
                                                         
 Line 1                                     7                      69/24 to 75/24 
 Line 2                                     7                      69/26 to 75/26 
 Line 3                                     7                      69/28 to 75/28 
 Line 4                                     7                      69/30 to 75/30 
 Line 5                                     7                      69/32 to 75/32 
 Line 6a                                    7                      69/35 to 75/35 
 Line 6b                                    7                      69/37 to 75/37 
 Line 6c                                    7                      69/39 to 75/39 
 Line 7                                     7                      69/41 to 75/41 
 Line 8                                     7                      69/43 to 75/43 
 Line 9                                     7                      69/45 to 75/45 
 Line 10a                                   7                      69/48 to 75/48 
 Line 10b                                   7                      69/50 to 75/50 
 Line 10c                                   7                      69/52 to 75/52 

                                            32 



- 33 -
                                          2020 BIRT - Schedule B 
                                    Form Barcode Number: 30520 
                                          Barcode Type: Code 3 of 9 
 Top Barcode X/Y Position:          38/4      Bottom Barcode X/Y Position:             56/64 
 Top Barcode Narrow Bar Width:      17 mils   Bottom Barcode Narrow Bar Width:         20 mils 
 Top Barcode Narrow to Width Ratio:  2.5      Bottom Barcode Narrow to Width Ratio:    3.0 

  Line 2i and Line 6 include Numeric and Punctuation Characters (decimal point). 
 
  Field                                     # of chars.             X/Y Start Position 
                                                         
  Top Left Reg. Mark                                                7/5 
  Top Right Reg. Mark                                               80/5 
  Bottom Left Reg. Mark                                             7/64 
  Bottom Right Reg. Mark                                            80/64 

  City Account Number                       7                       64/6   to 80/6 

  Line 1 Check Box                          1                       62/13 to 62/13 
  Line 1                                    9                       68/13 to 76/13 
  Line 2a                                   9                       68/18 to 76/18 
  Line 2b Check Box                         1                       62/20 to 62/20 
  Line 2b                                   9                       68/20 to 76/20 
  Line 2c Check Box                         1                       62/22 to 62/22 
  Line 2c                                   9                       68/22 to 76/22 
  Line 2d Check Box                         1                       62/24 to 62/24 
  Line 2d                                   9                       68/24 to 76/24 
  Line 2e                                   9                       68/28 to 76/28 
  Line 2f Check Box                         1                       62/30 to 62/30 
  Line 2f                                   9                       68/30 to 76/30 
  Line 2g                                   9                       68/32 to 76/32 
  Line 2h                                   9                       68/34 to 76/34 
  Line 2i                                   8                       69/36 to 76/36 
  Line 2j Check Box                         1                       62/38 to 62/38 
  Line 2j                                   9                       68/38 to 76/38 
  Line 3 Check Box                          1                       62/40 to 62/40 
  Line 3                                    9                       68/40 to 76/40 
  Line 4 Check Box                          1                       62/42 to 62/42 
  Line 4                                    9                       68/42 to 76/42 
  Line 5 Check Box                          1                       62/44 to 62/44 
  Line 5                                    9                       68/44 to 76/44 
  Line 6                                    8                       69/46 to 76/46 
  Line 7 Check Box                          1                       62/48 to 62/48 
  Line 7                                    9                       68/48 to 76/48 
  Line 8 Check Box                          1                       62/50 to 62/50 
  Line 8                                    9                       68/50 to 76/50 
  Line 9 Check Box                          1                       62/52 to 62/52 
  Line 9                                    9                       68/52 to 76/52 
  Line 10                                   9                       68/54 to 76/54 
  Line 11                                   9                       68/56 to 76/56 
  Line 12 Check Box                         1                       62/58 to 62/58 
  Line 12                                   9                       68/58 to 76/58 
  Line 13                                   9                       68/60 to 76/60 

                                            33 



- 34 -
                                         2020 BIRT - Schedule C-1 
                                    Form Barcode Number: 30620 
                                         Barcode Type: Code 3 of 9 
 Top Barcode X/Y Position:          38/4       Bottom Barcode X/Y Position:             56/64 
 Top Barcode Narrow Bar Width:      17 mils    Bottom Barcode Narrow Bar Width:         20 mils 
 Top Barcode Narrow to Width Ratio:  2.5       Bottom Barcode Narrow to Width Ratio:    3.0 

                           If Line 12 is equal to 100% the BIRT-EZ return must be used. 

        Line 3 include Numeric and Punctuation Characters (decimal point). 

 Field                                      # of chars.            X/Y Start Position 
 
 Top Left Reg. Mark                                                7/5 
 Top Right Reg. Mark                                               80/5 
 Bottom Left Reg. Mark                                             7/64 
 Bottom Right Reg. Mark                                            80/64 
 
 City Account Number                        7                      65/6   to 71/6 
 
 Line 1                                     11                     66/41 to 76/41 
 Line 2                                     11                     66/43 to 76/43 
 Line 3                                     8                      69/45 to 76/45 

                                            34 



- 35 -
                                          2020 BIRT - Schedule D  
                                    Form Barcode Number: 30720 
                                         Barcode Type: Code 3 of 9 
 Top Barcode X/Y Position:          38/4       Bottom Barcode X/Y Position:           56/64 
 Top Barcode Narrow Bar Width:      17 mils    Bottom Barcode Narrow Bar Width:       20 mils 
 Top Barcode Narrow to Width Ratio:  2.5       Bottom Barcode Narrow to Width Ratio:  3.0 
 
  Field                                     # of chars.            X/Y Start Position 
                                                         
  Top Left Reg. Mark                                               7/5 
  Top Right Reg. Mark                                              80/5 
  Bottom Left Reg. Mark                                            7/64 
  Bottom Right Reg. Mark                                           80/64 

  City Account Number                       7                      64/6   to 70/6 

  Line 1                                    11                     66/17 to 76/17 
  Line 2                                    11                     66/19 to 76/19 
  Line 3                                    11                     66/21 to 76/21 
  Line 4                                    11                     66/23 to 76/23 
  Line 5a                                   11                     66/25 to 76/25 
  Line 5b                                   11                     66/27 to 76/27 
  Line 5c                                   11                     66/29 to 76/29 
  Line 5d                                   11                     66/31 to 76/31 
  Line 6                                    11                     66/33 to 76/33 
  Line 7                                    11                     66/35 to 76/35 
  Line 8                                    11                     66/37 to 76/37 
  Line 9                                    11                     66/39 to 76/39 
  Line 10                                   11                     66/41 to 76/41 
  Line 11                                   11                     66/43 to 76/43 
  Line 12                                   11                     66/45 to 76/45 
  Line 13                                   11                     66/47 to 76/47 
 
                                            Worksheet S 
 
  Line S1                                   11                     66/51 to 76/51 
  Line S2                                   11                     66/53 to 76/53 
  Line S3                                   11                     66/55 to 76/55 
  Line S4                                   6                      71/57 to 76/57 
  Line S5                                   11                     66/59 to 76/59 

                                            35 



- 36 -
                                            2020 BIRT - Schedule A 
 
                                         Form Barcode Number: 30820 
                                          Barcode Type: Code 3 of 9 
 Top Barcode X/Y Position:          38/4       Bottom Barcode X/Y Position:            56/64 
 Top Barcode Narrow Bar Width:      17 mils    Bottom Barcode Narrow Bar Width:        20 mils 
 Top Barcode Narrow to Width Ratio:  2.5       Bottom Barcode Narrow to Width Ratio:   3.0 
 
  Field                                     # of chars.             X/Y Start Position 
                                                         
  Top Left Reg. Mark                                                7/5 
  Top Right Reg. Mark                                               80/5 
  Bottom Left Reg. Mark                                             7/64 
  Bottom Right Reg. Mark                                            80/64 

  City Account Number                       7                       66/6   to 72/6 

  Line 1 Check Box                          1                       63/21 to 63/21 
  Line 1                                    9                       69/21 to 77/21 
  Line 2 Check Box                          1                       63/23 to 63/23 
  Line 2                                    9                       69/23 to 77/23 
  Line 3 Check Box                          1                       63/25 to 63/25 
  Line 3                                    9                       69/25 to 77/25 
  Line 4 Check Box                          1                       63/27 to 63/27 
  Line 4                                    9                       69/27 to 77/27 
  Line 5 Check Box                          1                       63/29 to 63/29 
  Line 5                                    9                       69/29 to 77/29 
  Line 6 Check Box                          1                       63/31 to 63/31 
  Line 6                                    7                       69/31 to 77/31 
  Line 7 Check Box                          1                       63/33 to 63/33 
  Line 7                                    9                       69/33 to 77/33 
  Line 8                                    8                       69/35 to 77/35 
  Line 9 Check Box                          1                       63/37 to 63/37 
  Line 9                                    9                       69/38 to 77/38 
  Line 10 Check Box                         1                       63/39 to 63/39 
  Line 10                                   9                       69/39 to 77/39 
  Line 11 Check Box                         1                       63/41 to 63/41 
  Line 11                                   9                       69/41 to 77/41 
  Line 12                                   9                       69/43 to 77/43 
  Line 13                                   9                       63/45 to 63/45 
  Line 14 Check Box                         1                       63/47 to 63/47 
  Line 14                                   9                       69/47 to 77/47 
  Line 15                                   9                       69/49 to 77/49 

                                            36 



- 37 -
                                          2020 BIRT - Schedule E  
                                    Form Barcode Number: 30920 
                                         Barcode Type: Code 3 of 9 
 Top Barcode X/Y Position:          38/4       Bottom Barcode X/Y Position:           56/64 
 Top Barcode Narrow Bar Width:      17 mils    Bottom Barcode Narrow Bar Width:       20 mils 
 Top Barcode Narrow to Width Ratio:  2.5       Bottom Barcode Narrow to Width Ratio:  3.0 
 
  Field                                     # of chars.            X/Y Start Position 
                                                         
  Top Left Reg. Mark                                               7/5 
  Top Right Reg. Mark                                              80/5 
  Bottom Left Reg. Mark                                            7/64 
  Bottom Right Reg. Mark                                           80/64 

  City Account Number                       7                      64/6   to 70/6 

  Line 1                                    11                     68/17 to 78/17 
  Line 2                                    11                     68/19 to 78/19 
  Line 3                                    11                     68/21 to 78/21 
  Line 4                                    11                     68/23 to 78/23 

  Line 5                                    11                     68/28 to 78/28 
  Line 6a                                   11                     68/31 to 78/31 
  Line 6b                                   11                     68/33 to 78/33 
  Line 7                                    11                     68/35 to 78/35 
  Line 8                                    11                     68/37 to 78/37 
  Line 9                                    11                     68/39 to 78/39 

  Line 10                                   11                     68/44 to 78/44 
  Line 11a                                  11                     68/47 to 78/47 
  Line 11b                                  11                     68/49 to 78/49 
  Line 12                                   11                     68/51 to 78/51 
  Line 13                                   11                     68/53 to 78/53 
  Line 14                                   11                     68/55 to 78/55 
  Line 15                                   11                     68/57 to 78/57 

                                            37 



- 38 -
                                          2020 BIRT - Schedule SC 
                                    Form Barcode Number: 31020 
                                          Barcode Type: Code 3 of 9 
 Top Barcode X/Y Position:          38/4      Bottom Barcode X/Y Position:             56/64 
 Top Barcode Narrow Bar Width:      17 mils   Bottom Barcode Narrow Bar Width:         20 mils 
 Top Barcode Narrow to Width Ratio:  2.5      Bottom Barcode Narrow to Width Ratio:    3.0 
                                                         
  Field                                     # of chars.             X/Y Start Position 
                                                          
  Top Left Reg. Mark                                                7/5 
  Top Right Reg. Mark                                               80/5 
  Bottom Left Reg. Mark                                             7/64 
  Bottom Right Reg. Mark                                            80/64 
                                                         
  City Account Number                       7                       63/6   to 69/6 
                                                         
  Line 1                                    9                       68/23 to 76/23 
  Line 2                                    9                       68/26 to 76/26 
  Line 3                                    9                       68/29 to 76/29 
  Line 4                                    9                       68/32 to 76/32 
  Line 5                                    9                       68/35 to 76/35 
  Line 6                                    9                       68/38 to 76/38 
  Line 7                                    9                       68/41 to 76/41 
  Line 8                                    9                       68/44 to 76/44 
  Line 9                                    9                       68/47 to 76/47 
  Line 10                                   9                       68/50 to 76/50 
  Line 11                                   9                       68/53 to 76/53 
  Line 12                                   9                       68/56 to 76/56 
  Line 13                                   9                       68/59 to 76/59 

                                            38 



- 39 -
                                          2020 BIRT - Worksheet N 
                                    Form Barcode Number: 31120 
                                         Barcode Type: Code 3 of 9 
 Top Barcode X/Y Position:          38/4       Bottom Barcode X/Y Position:                56/64 
 Top Barcode Narrow Bar Width:      17 mils    Bottom Barcode Narrow Bar Width:            20 mils 
 Top Barcode Narrow to Width Ratio:  2.5       Bottom Barcode Narrow to Width Ratio:       3.0 
 
  Field                                     # of chars.                 X/Y Start Position 
                                                         
 Top Left Reg. Mark                                                     7/5 
 Top Right Reg. Mark                                                    80/5 
 Bottom Left Reg. Mark                                                  7/64 
 Bottom Right Reg. Mark                                                 80/64 

 City Account Number                        7                           64/6  to 70/6 

                                    Section 1 for BIRT Long Form Filers 
 
  Line 1 Check Box                          1                           59/16 to 59/16 
 Line 1                                     9                           68/16 to 76/16 
 Line 3                                     9                           68/23 to 76/23 
 
                                         Section 2 for BIRT - EZ Filers 
 
  Line 1 Check Box                          1                           59/32 to 59/32 
 Line 1                                     9                           68/32 to 76/32 
 Line 3                                     9                           68/39 to 76/39 
 
                                         Section 3 for BIRT H-J Filers 
 
  Line 1 Check Box                          1                           59/49 to 59/49 
 Line 1                                     9                           68/49 to 76/49 
 Line 3                                     9                           68/56 to 76/56 

                                            39 



- 40 -
                                                                                                                                                   2020 BIRT
                      CITY OF PHILADELPHIA                  30420                                                                                  DUE DATE:  APRIL 15, 2021
                    DEPARTMENT OF REVENUE
        2020 BUSINESS INCOME & RECEIPTS TAX                                                                                                             City Account Number
        For business conducted in and out of Philadelphia
                                                                                                                                                        7777777

   Name and address..................Line 1                                                                                                        EIN  999999999
   Name and address..................Line 2
   Name and address..................Line 3                                                                                                        SSN  999999999
   Name and address..................Line 4
   Name and address..................Line 5                                                                                                        Taxpayer E-mail Address
                                                                                      aaaaaaaaaaaaaaaaaaaaaaaaaa.ddd
If this is a change of address, file a Change Form and check this box:       X

If your business terminated in 2020, enter the termination date   AND   file a CHANGE FORM.                                                        mm-dd-yyyy
                                                                                                                      
YOU MUST COMPLETE WORKSHEET "S" and SCHEDULE "C-1"                                                                    If this is an amended return place an "X" here:            X
   COMPUTATION OF TAX DUE OR OVERPAYMENT
   1. NET INCOME PORTION OF TAX (from Schedule B, Line 13 or
           Schedule A, Line 15.  If there is no tax due, enter "0"...................................................................              1.   9999999
   2. GROSS RECEIPTS PORTION OF TAX (from Schedule D, Line 13).
           If there is no tax due, enter "0"...................................................................................................... 2.   9999999

   3. Tax Due for the 2020 Business Income & Receipts Tax (Line 1 plus Line 2)................................                                     3.   9999999

   4. MANDATORY 202 1BIRT Estimated Payment  (See Instructions)              ...........................................                           4.   9999999

   5. Total Due by    4/15/202  1(Line 3 plus Line 4)................................................................................              5.   9999999
   ESTIMATED PAYMENTS AND OTHER CREDITS
   6a.    Include any estimated and/or extension payments of 2020 BIRT previously made,
            and any credit from overpayment of the 2019BIRT and/or 2020 NPT return.........................                                        6a.  9999999

   6b.  Credit from Special Credit Schedule (SC).  (Cannot exceed amount on Line 3)...........................                                     6b.  9999999

   6c.  Total payments and credits.  (Line 6a plus Line 6b).....................................................................                   6c.  9999999
   7. Net Tax Due (Line 5 less Line 6c).
           If Line 6c is greater than Line 5, enter "0"....................................................................................        7.   9999999
   8. Interest and Penalty
           Refer to web site for current percentage......................................................................................          8.   9999999
   9.  TOTAL DUE including Interest and Penalty (Line 7 plus Line 8).
             Use payment coupon.  Make check payable to:  "City of Philadelphia".................................                                  9.   9999999

   OVERPAYMENT OPTIONS    If Line 6C is greater than Line 5, enter the amount to be:
   10a.  Refunded.    Do not file a separate Refund Petition.........................................................                              10a. 9999999

   10b.  Applied to the 2020 Net Profits Tax Return................................................................................                10b. 9999999

   10c.  Applied to the 2021 Business Income & Receipts Tax...............................................................                         10c. 9999999

                Under penalties of perjury, as set forth in 18 PA C.S. §§ 4902-4903 as amended, I swear that I have reviewed this return
                and accompanying statements and schedules, and to the best of my knowledge and belief, they are true and complete.
   Taxpayer Signature________________________________________  Date_______________________Phone #_________________________

   Preparer Signature_________________________________________ Date_______________________Phone #_________________________

                                                                                                                                                   Vendor Name & Sumbission Date 
                                                            BIRT - Page 1



- 41 -
                                                                                                                                               City Account Number
          2020 BIRT               30520
                                                                                                                                                 7777777
          SCHEDULE B
COMPUTATION OF TAX ON NET INCOME (METHOD II)
Reminder -   You   must use the same method (METHOD I or METHOD II) that you elected on the first Business Income & Receipts Tax return
filed.    If you are using Schedule B, do not complete or file Schedule A.

1. Net Income (Loss) as properly reported to the Federal Government...........................................                             1.  X 999999999

2.  ADJUSTMENTS (Per BIRT Reg. 404 and Public Law 86-272)
(a) Income net of interest expense attributable to direct obligations of the Federal
        Government, Pennsylvania or the political subdivisions of Pennsylvania.
        (If less than zero, enter zero on this line)...............................................................................        2a.   999999999

(b)  Net Income (Loss) from certain port related activities.   (Reg. 302 (T)).................................                             2b. X 999999999
(c)  Net Income (Loss) from  specific PUC and ICC business activities.
      (Reg. 101 (D)(3))..................................................................................................................  2c. X 999999999

(d)  Net Income (Loss) from Public Law 86-272 activities...........................................................                        2d. X 999999999

(e)  Receipts by corporations of dividends, interest and royalties received from other
      corporations in the same affiliated group and/or from other corporations of which
      the receiving corporation owns at least 20% of the stock and/or
      BIRT Regulation §404 (B)(5) adjustments (Reg. 302 (O))....................................................                           2e.   999999999

(f)  Line 1 minus Lines 2a through 2e.........................................................................................             2f. X 999999999
(g)  All other receipts from other corporations of the same affiliated group.
      (Reg. 302 (N))...................................................................................................................... 2g.   999999999

(h)  Gross Receipts per BIRT Regulation §404(B)(5)(e).............................................................                         2h.   999999999

(i)  Divide Line g by Line h and enter the result here...................................................................                  2i.   9.999999

(j)  Multiply Line f by Line i and enter the result here...................................................................                2j. X 999999999

3. ADJUSTED NET INCOME (LOSS)  (Line 2f minus Line 2j).......................................................                              3.  X 999999999

4. Total Nonbusiness Income (Loss).............................................................................................            4.  X 999999999

5. Income (Loss) to be apportioned (Line 3 minus Line 4).............................................................                      5.  X 999999999

6. Apportionment Percentage from Schedule C-1, Line 3...............................................................                       6.    9.999999

7. Income (Loss) apportioned to Philadelphia (Line 5 times Line 6)................................................                         7.  X 999999999

8. Nonbusiness Income (Loss) allocated to Philadelphia................................................................                     8.  X 999999999

9. Current year Income (Loss) (Line 7 plus Line 8).........................................................................                9.  X 999999999
10.  Statutory Net Income Deduction from Worksheet S, Line S5.
     (Must complete Schedule C-1.)................................................................................................         10.   999999999

11. Loss Carry Forward, if any..........................................................................................................   11.   999999999

12. Taxable Income (Loss) (Line 9 minus Line 10 minus Line 11)....................................................                         12. X 999999999

13.  TAX DUE   (Line 12 times .0620)   If Line 12 is a loss, enter zero................................................                    13.   999999999
ENTER HERE AND ON PAGE 1, LINE 1 OF THIS RETURN.

                                                                                                                                           Vendor Name & Sumbission Date 
                                  BIRT - Sch. B



- 42 -
      2020 BIRT                                  30620                                                              City Account Number
                                                                                                                    7777777
    SCHEDULE C-1
For business conducted in and out of Philadelphia

The Department has adopted a   Single Sales/Receipts Factor Apportionment methodology for BIRT.
The Property and Payroll Factors are   no longer used in the calculation of the Philadelphia Apportionment
percentage.  The  Single  Sales/Receipts  Factor  Apportionment  percentage  is  the  ratio  of   Philadelphia
Sales/Receipts to   Total Sales/Receipts everywhere  .

The   sourcing of sales/receipts is the   same as it has been in prior years. Receipts and Taxable Receipts
are defined at   Philadelphia Code § 19-2601 and explained in Article III of the BIRT Regulations.

                               www.phila.gov/revenue/birt-regs

Market-Based Sourcing of Service/Sales for Software Companies

A   Software Company (as defined by BIRT Regulations Section 101DD) is to source sales/receipts (for
both the Receipts and Net Income bases) in accordance with   Market-based sourcing. That is, the sale
of products and the performance of services will be deemed to be the location where the recipient
receives the benefit of the products and services.

      This schedule must be completed in order to receive the deduction from Worksheet S.

COMPUTATION OF APPORTIONMENT FACTOR TO BE APPLIED TO APPORTIONABLE NET INCOME.    YOU
MUST COMPLETE SCHEDULE C-1 IF YOU ARE APPORTIONING YOUR INCOME.  FAILURE TO INCLUDE THIS SCHEDULE WITH YOUR
RETURN MAY RESULT IN THE DISALLOWANCE OF YOUR APPORTIONMENT AND YOU MAY BE BILLED.

1. Philadelphia Sales/Receipts (From Schedule D line 6)......................................................... 1. 99999999999

2. Gross Sales/Receipts Everywhere (From Schedule D line 4)...............................................       2. 99999999999

3. Single Sales/Receipts Factor Apportionment Percentage (Line 1 divided by 2)....................               3. 9.999999

ENTER THE PHILADELPHIA RECEIPTS FACTOR APPORTIONMENT PERCENTAGE ON SCHEDULE A, LINE 8   OR SCHEDULE B, LINE 6.

    DO NOT FILE THIS RETURN if Line 3 is equal to 100%.  Use the BIRT-EZ return which is available at
                                          www.phila.gov/revenue.

                    Do not submit Schedule C-1 with the BIRT-EZ return.

                                                                                                                 Vendor Name & Sumbission Date 
                                                 BIRT - Sch. C-1



- 43 -
                                                                                                                                           City Account Number
     2020 BIRT                                     30720
                                                                                                                                               7777777
     SCHEDULE D
COMPUTATION OF TAX ON GROSS RECEIPTS
The following taxpayers should not file Schedule D.
   ꞏ Taxpayers registered under the Pennsylvania Securities Act of 1972;
   ꞏ Persons subject to a tax imposed pursuant to Article VII, VIII, IX or XV of the Tax Reform Code of 1971 (Banks, Title Insurance 
        Companies, Trust Companies, Insurance Companies and Mutual Thrift Institutions)
      ꞏ Other Financial Businesses
These industries should file Schedules H-J, available on our website at   www.phila.gov/revenue.
                        Do not report negative numbers on this schedule.
1. Gross Receipts from sales and/or rentals of tangible personal property, dividends,
   interest, royalties, and gains on sale of stocks, bonds and business capital assets.....................                                1.  99999999999

2. Gross Receipts from services......................................................................................................      2.  99999999999

3. Gross Receipts from rentals of real property................................................................................            3.  99999999999

4. Total of Lines 1 through 3............................................................................................................. 4.  99999999999
5. Less exclusions from:
  5a.  Sales delivered outside of Philadelphia...............................................................................              5a. 99999999999

     5b.  Services performed outside of Philadelphia........................................................................               5b. 99999999999

     5c.  Rentals of real property outside of Philadelphia..................................................................               5c. 99999999999

     5d.  Other (specify)_______________________.......................................................................                    5d. 99999999999

6. Net Taxable Receipts before Statutory Exclusion (Line 4 minus Lines 5a through 5d).................                                     6.  99999999999

7.  Statutory Exclusion (Lower of Line 6 or $100,000.00).............................................................                      7.  99999999999

8. Net Taxable Receipts   after Statutory Exclusion (Line 6 minus Line7)..........................................                         8.  99999999999
9. Receipts on which tax is to be computed by the Alternate Method.
   (Enter here and on Schedule E, Line 1, 5 or 10.).........................................................................               9.  99999999999

10. Receipts subject to tax at the regular rate (Line 8 minus Line 9).................................................                     10. 99999999999

11.  TAX DUE at the regular rate.  (Line 10 times .001415)...............................................................                  11. 99999999999

12.  TAX DUE using the Alternate Method from Schedule E, Line 15, if applicable...........................                                 12. 99999999999

13.  TOTAL TAX DUE  (Line 11 plus Line 12)...................................................................................              13. 99999999999
Enter here and on Page 1, Line 2 of this return.

Worksheet S - Use to calculate Statutory Net Income Deduction
S1.  Enter the lower of Line 6 above or $100,000.......................................................................                    S1. 99999999999
S2.  Enter Current Year Income from Line 11 of Schedule A or Line 9 of Schedule B.
  If loss, enter zero.................................................................................................................     S2. 99999999999

S3.  Enter Net Taxable Receipts from Line 6 above...................................................................                       S3. 99999999999

S4.  Divide Line S2 by Line S3.  (Cannot be greater than 1.0000)..............................................                             S4. 9.9999

S5.  Statutory Net Income Deduction (Line S1 times Line S4.  Cannot exceed $100,000).........                                              S5. 99999999999
   Enter here and on Line 12 of Schedule A or Line 10 of Schedule B.

                                                                                                                                           Vendor Name & Sumbission Date 
                                                   BIRT - Sch. D



- 44 -
     2020 BIRT                                                                                                                              City Account Number
                                          30820
                                                                                                                                              7777777
     SCHEDULE A
COMPUTATION OF TAX ON NET INCOME (METHOD I)

To be used by taxpayers electing to report net income from the operation of a business in accordance with their accounting system, after
subtracting from gross receipts the cost of goods sold and all ordinary and necessary expenses of doing business, rather than as reported to
and ascertained by the Federal Government.

Reminder -   You   must use the same method (METHOD I or METHOD II) that you elected on the first Business Income and Receipts Tax
return filed.    If you are using  Schedule A, do not complete or file Schedule B.

1. Net Income (Loss) per accounting system used plus income taxes deducted
   in arriving at Net Income........................................................................................................... 1.  X 999999999

2. Net Income (Loss) from certain port related activities...............................................................                2.  X 999999999

3. Net Income (Loss) from  specific PUC and ICC business activities..........................................                           3.  X 999999999

4. Net Income (Loss) from Public Law 86-272 activities...............................................................                   4.  X 999999999

5. Adjusted Net Income (Loss) (Line 1 minus Lines 2, 3 and 4)....................................................                       5.  X 999999999

6. Total Nonbusiness Income (Loss)............................................................................................          6.  X 999999999

7. Income (Loss) to be apportioned (Line 5 minus Line 6)............................................................                    7.  X 999999999

8. Apportionment Percentage from Schedule C-1, Line 3............................................................                       8.    9.999999

9.  Income (Loss) apportioned to Philadelphia (Line 7 times Line 8)......................................                               9.  X 999999999

10. Nonbusiness Income (Loss) allocated to Philadelphia.............................................................                    10. X 999999999

11. Current year Income (Loss) (Line 9 plus Line 10)....................................................................                11. X 999999999
12.  Statutory Net Income Deduction from Worksheet S, Line S5.
    (Must complete Schedule C-1.)............................................................................................           12.   999999999

13. Loss Carry Forward, if any......................................................................................................    13.   999999999

14. Taxable Income (Loss) (Line 11 minus Line 12 minus Line 13)..............................................                           14. X 999999999

15.  TAX DUE   (Line 14 times .0620)  If Line 14 is a loss, enter zero..............................................                    15.   999999999
ENTER HERE AND ON PAGE 1, LINE 1 OF THIS RETURN.

                                                                                                                                        Vendor Name & Sumbission Date 
                                          BIRT - Sch. A



- 45 -
     2020 BIRT                                                                                                                                    City Account Number
                     30920
                                                                                                                                                  7777777
     SCHEDULE E
COMPUTATION OF TAX ON GROSS RECEIPTS

ALTERNATE METHOD OF COMPUTING TAX ON GROSS RECEIPTS, MUST COMPLETE SCHEDULE D.
(To be used by Manufacturers, Wholesalers and Retailers electing to use the Alternate Method of computation.)
SEE BUSINESS INCOME AND RECEIPTS TAX REGULATIONS (SECTION 305) AT   WWW.PHILA.GOV/REVENUE.

A.  MANUFACTURERS

1. Receipts on which tax is to be computed by the Alternate Method (from Schedule D, Line 9)...................                                   1.   99999999999

2. Cost of goods sold for the receipts reported on Line 1..............................................................................           2.   99999999999

3. TAX BASE (Line 1 minus Line 2)..............................................................................................................   3.   99999999999

4.  TAX DUE (Line 3 times .023400).  If Line 3 is a loss, enter zero...............................................................               4.   99999999999

B.  WHOLESALERS

5. Receipts on which tax is to be computed by the Alternate Method (from Schedule D, Line 9)...................                                   5.   99999999999

6. Applicable Cost of Goods for the receipts reported on Line 5:
             (a) Cost of material...............................................................................................................  6a.  99999999999

             (b) Cost of Labor..................................................................................................................  6b.  99999999999

7. TOTAL APPLICABLE COST OF GOODS (Line 6a plus 6b).....................................................................                          7.   99999999999

8. TAX BASE (Line 5 minus Line 7)..............................................................................................................   8.   99999999999

9.  TAX DUE (Line 8 times .0329).  If Line 8 is a loss, enter zero...................................................................             9.   99999999999

C.  RETAILERS

10. Receipts on which tax is to be computed by the Alternate Method (from Schedule D, Line 9)..................                                   10.  99999999999

11. Applicable Cost of Goods for the receipts reported on Line 10:
             (a) Cost of material................................................................................................................ 11a. 99999999999

             (b) Cost of Labor..................................................................................................................  11b. 99999999999

12. TOTAL APPLICABLE COST OF GOODS (Line 11a plus 11b)...............................................................                             12.  99999999999

13. TAX BASE (Line 10 minus Line 12)........................................................................................................      13.  99999999999

14.  TAX DUE  (Line 13 times .0078).  If Line 13 is a loss, enter zero.............................................................               14.  99999999999

15.  TOTAL TAX DUE   (Total of Lines 4, 9 and 14).........................................................................................        15.  99999999999
Enter the amount from Line 15 on Schedule D, Line 12.

                                                                  Vendor Name & Sumbission Date  
                     BIRT - Sch. E



- 46 -
     2020 BIRT                                               31020                                                                                City Account Number
                                                                                                                                                      7777777
     SCHEDULE SC
     SPECIAL CREDIT SCHEDULE                                      Important Note

Schedule SC is to be used by a taxpayer participating in any of the BIRT Tax Credit Programs (listed below) in order to 
claim the applicable credit on their 2020 BIRT return.  A taxpayer     must have made an application to participate in and 
been accepted into the respective program by the Revenue Department.  Also, the taxpayer  must fulfill all statutory and 
regulatory requirements to participate in the respective Tax Credit Program (e.g., entering into commitment agreements 
with the Department and complying with its terms and conditions, tax compliance, etc.).  A taxpayer not meeting all the 
requirements for participation in the respective BIRT Tax Credit Program will not receive the applicable credit.

For  more  information  on  the  various  BIRT  Tax  Credit  Programs,  please  refer  to  the  Department's  website  at
http://www.phila.gov/Revenue/taxpro/Pages/TaxCredits.aspx.

1. Credit for Contributions to Community Development Corporations,
   (Nonprofit Organizations engaged in developing and implementing
     Healthy Food Initiatives and Nonprofit Intermediaries).........................................................................              1.  999999999

2. Credit for New Job Creation.................................................................................................................   2.  999999999

3. Green Roof Tax Credit......................................................................................................................... 3.  999999999

4. Philadelphia Re-Entry Employment Program for
     Returning Citizens Tax Credit ("PREP")...............................................................................................        4.  999999999

5. Sustainable Business Tax Credit.........................................................................................................       5.  999999999

6. Credit for Employment of Returning Veterans of the Armed Forces.....................................................                           6.  999999999

7. Life Partner and Transgender Care Health Benefits Tax Credits..........................................................                        7.  999999999

8. Distressed Business Tax Credit...........................................................................................................      8.  999999999

9. Keystone Opportunity Zones Tax Credits (KOZ/KOEZ/KOIZ)
     from KOZ Worksheet Line 10...............................................................................................................    9.  999999999

10. Strategic Development Area Tax Credit...............................................................................................          10. 999999999

11. Economic Development District Tax Credit..........................................................................................            11. 999999999

12. Healthy Beverage Tax Credit...............................................................................................................    12. 999999999

13.  TOTAL CREDITS  (Add Lines 1 through 12)........................................................................................              13. 999999999
   Enter the amount of Line 13 on Page 1, Line 6b of the 2020 BIRT or BIRT-EZ 
   Return.(Cannot exceed amount on Page 1, Line 3.)

                                                                                                                                                  Vendor Name & Sumbission Date 
                                                             BIRT - Sch. SC



- 47 -
        2020 BIRT and NPT Returns
                                                                       31120                                                          City Account Number
        WORKSHEET  N                                                                                                                  7777777
   New Business and Employment Worksheet
             (Philadelphia Code 19-3800)

   To be used by taxpayers who are claiming new business status under Philadelphia code 19-3800.
                 Taxpayer must first complete the eligibility questionnaire to use this worksheet.
                                           For Business Income & Receipts Tax Long Form Filers
COMPUTATION OF TAX ON NET INCOME

1. Enter the amount of taxable income from Schedule A, Line 14 or Schedule B, Line 12.
   To report a net loss, check the box.......................................................................................... 1. X 999999999

2. Tax Due as computed for new business.................................................................................         2.
   Enter the amount of Line 2 on BIRT Page 1, Line 1 and if liable, NPT Page 1, Line 11.                                                                           0.00

COMPUTATION OF TAX ON GROSS RECEIPTS

3. Enter the taxable gross receipts from Schedule D, Line 8....................................................                  3.   999999999

4. Tax Due as computed for new business...............................................................................           4.
                                                                                                                                                                   0.00
   Enter the amount of Line 4 on BIRT Page 1, Line 2.
                                              For Business Income & Receipt Tax - EZ Filers

COMPUTATION OF TAX ON NET INCOME

1. Enter the amount of taxable income from BIRT-EZ Page 2, Line 5
   To report a net loss, check the box.......................................................................................... 1. X 999999999

2. Tax Due as computed for new business.................................................................................         2.
                                                                                                                                                                   0.00
   Enter the amount of Line 2 on BIRT-EZ Page 1, Line 1 and if liable, NPT Page 1, Line 11.

COMPUTATION OF TAX ON GROSS RECEIPTS

3. Enter the taxable gross receipts from BIRT-EZ Page 2, Line 10............................................                     3.   999999999

4. Tax Due as computed for new business.................................................................................         4.
   Enter the amount of Line 4 on BIRT-EZ Page 1, Line 2.                                                                                                           0.00

                                      For Business Income & Receipts Tax Schedule H-J Filers

COMPUTATION OF TAX ON NET INCOME

1. Enter the amount of taxable income from Schedules H-J (Schedule A or B),
   Line 12   or  (Schedule H-1), Line 11.  To report a net loss, check the box...............................                    1. X 999999999

2. Tax Due as computed for new business.................................................................................         2.
   Enter the amount of Line 2 on BIRT Page 1, Line 1 and if liable, NPT Page 1, Line 11.                                                                           0.00

COMPUTATION OF TAX ON GROSS RECEIPTS

3. Enter the taxable gross receipts from Schedule H-J (Schedule H), Line 10 or 24..................                              3.   999999999

4. Tax Due as computed for new business..................................................................................        4.
Enter the amount of Line 4 on BIRT Page 1, Line 2.                                                                                                                 0.00

Important Note:  Use Worksheet N to complete Page 1 of the BIRT return and if liable, Page 1 of the NPT return, Line 11.

                                                                                                                                    Vendor Name & Sumbission Date  
                                                                       BIRT - Wrksht N



- 48 -
                           2020 Business Income and Receipts Tax - EZ Page 1 
                                    Form Barcode Number: 31220 
                                         Barcode Type: Code 3 of 9 
 Top Barcode X/Y Position:          38/4        Bottom Barcode X/Y Position:          56/64 
 Top Barcode Narrow Bar Width:      17 mils     Bottom Barcode Narrow Bar Width:      20 mils 
 Top Barcode Narrow to Width Ratio:  2.5        Bottom Barcode Narrow to Width Ratio: 3.0 
 
  Variable Field                             # of chars.           X/Y Position 
                                                          
  Top Left Reg. Mark                                               7/5 
  Top Right Reg. Mark                                              80/5 
  Bottom Left Reg. Mark                                            7/64 
  Bottom Right Reg. Mark                                           80/64 

  Name & Address Line 1                      40                    8/11   to 47/11 
  Name & Address Line 2                      40                    8/12   to 47/12 
  Name & Address Line 3                      40                    8/13   to 47/13 
  Name & Address Line 4                      40                    8/14   to 47/14 
  Name & Address Line 5                      40                    8/15   to 47/15 
  E-mail Address                             30                    50/16 to 79/16 
  Change of Address Box                      1                     45/17 to 45/17 

  City Account Number                        7                     63/9   to 69/9 
  Federal Identification Number              9                     62/11 to 70/11 
  Social Security Number                     9                     62/13 to 70/13 

  Termination Date                           10                    61/19 to 70/19 
  Amended Return Check Box                   1                     80/21 to 80/21 

  Line 1                                     7                     69/24 to 75/24 
  Line 2                                     7                     69/26 to 75/26 
  Line 3                                     7                     69/28 to 75/28 
  Line 4                                     7                     69/30 to 75/30 
  Line 5                                     7                     69/32 to 75/32 
  Line 6a                                    7                     69/35 to 75/35 
  Line 6b                                    7                     69/37 to 75/37 
  Line 6c                                    7                     69/39 to 75/39 
  Line 7                                     7                     69/41 to 75/41 
  Line 8                                     7                     69/43 to 75/43 
  Line 9                                     7                     69/45 to 75/45 
  Line 10a                                   7                     69/48 to 75/48 
  Line 10b                                   7                     69/50 to 75/50 
  Line 10c                                   7                     69/52 to 75/52 

                                             48 



- 49 -
                           2020 Business Income and Receipts Tax - EZ Page 2 
                                          Barcode Number: 31320 
                                          Barcode Type: Code 3 of 9 
 Top Barcode X/Y Position:          38/4       Bottom Barcode X/Y Position:            56/64 
 Top Barcode Narrow Bar Width:      17 mils    Bottom Barcode Narrow Bar Width:        20 mils 
 Top Barcode Narrow to Width Ratio:  2.5       Bottom Barcode Narrow to Width Ratio:   3.0 
 
  Field                                     # of chars.             X/Y Start Position 
                                                         
  Top Left Reg. Mark                                                7/5 
  Top Right Reg. Mark                                               80/5 
  Bottom Left Reg. Mark                                             7/64 
  Bottom Right Reg. Mark                                            80/65 

  City Account Number                       7                       63/6   to 69/6 

  Line 1 Check Box                          1                       62/12 to 62/12 
  Line 1                                    9                       68/12 to 76/12 
  Line 2 Check Box                          1                       62/14 to 62/14 
  Line 2                                    9                       68/14 to 76/14 
  Line 3                                    9                       68/16 to 76/16 
  Line 4                                    9                       68/18 to 76/18 
  Line 5 Check Box                          1                       62/20 to 62/20 
  Line 5                                    9                       68/20 to 76/20 
  Line 6                                    9                       68/22 to 76/22 

  Line 7a                                   11                      66/27 to 76/27 
  Line 7b                                   11                      66/29 to 76/29 
  Line 7c                                   11                      66/31 to 76/31 
  Line 7d                                   11                      66/33 to 76/33 
  Line 7e                                   11                      66/35 to 76/35 
  Line 7f                                   11                      66/37 to 76/37 
  Line 7g                                   11                      66/39 to 76/39 
  Line 7h                                   11                      66/41 to 76/41 
  Line 7i                                   11                      66/43 to 76/43 
  Line 8                                    11                      66/45 to 76/45 
  Line 9                                    11                      66/47 to 76/47 
  Line 10                                   11                      66/49 to 76/49 
  Line 11                                   11                      66/51 to 76/51 
 
                                            Worksheet S 
 
  Line S1                                   11                      66/54 to 76/54 
  Line S2                                   11                      66/56 to 76/56 
  Line S3                                   11                      66/58 to 76/58 
  Line S4                                   6                       71/60 to 76/60 
  Line S5                                   11                      66/62 to 76/62 

                                            49 



- 50 -
                                                                                                                                                  2020 BIRT-EZ
                                                            31220
                          CITY OF PHILADELPHIA                                                                                                    DUE DATE:  APRIL 15, 2021
                      DEPARTMENT OF REVENUE
        2020 BUSINESS INCOME & RECEIPTS TAX                                                                                                           City Account Number
            For business conducted 100% in Philadelphia                                                                                                7777777

   Name and address..................Line 1                                                                                                       EIN  999999999
   Name and address..................Line 2
   Name and address..................Line 3                                                                                                       SSN  999999999
   Name and address..................Line 4
   Name and address..................Line 5                                                                                                       Taxpayer E-mail Address
                                                                                      aaaaaaaaaaaaaaaaaaaaaaaaaa.ddd
If this is a change of address, file a Change Form and check this box:       X

If your business terminated in 2020, enter the termination date   AND   file a CHANGE FORM.                                                           mm-dd-yyyy
                                                                                                                        
YOU MUST COMPLETE WORKSHEET "S-EZ"                                                  If this is an amended return place an "X" here:                                             X
   COMPUTATION OF TAX DUE OR OVERPAYMENT
   1. NET INCOME PORTION OF TAX (from Page 2, Line 6).
          If there is no tax due, enter "0"...................................................................................................... 1.   9999999
   2. GROSS RECEIPTS PORTION OF TAX (from Page 2, Line 11).
          If there is no tax due, enter "0"...................................................................................................... 2.   9999999

   3. Tax Due for the 2020 Business Income & Receipts Tax (Line 1 plus Line 2)..............................                                      3.   9999999

   4. MANDATORY 202 1BIRT Estimated Payment  (See Instructions)         ..........................................                                4.   9999999

   5. Total Due by    4/15/202   1   (Line 3 plus Line 4)................................................................................         5.   9999999
   ESTIMATED PAYMENTS AND OTHER CREDITS
     6a.    Include any estimated and/or extension payments of 2020 BIRT previously made
           and any credit from overpayment of the 201 9BIRT and/or 2020 NPT return......................                                          6a.  9999999

     6b.  Credit from Special Credit Schedule (SC).  (Cannot exceed amount on Line 3)........................                                     6b.  9999999

     6c.  Total payments and credits.  (Line 6a plus Line 6b)....................................................................                 6c.  9999999
   7. Net Tax Due (Line 5 less Line 6c).
         If Line 6c is greater than Line 5, enter "0"......................................................................................       7.   9999999
   8. Interest and Penalty
         Refer to web site for current percentage........................................................................................         8.   9999999
   9.  TOTAL DUE including Interest and Penalty (Line 7 plus Line 8).
            Use payment coupon.  Make check payable to:  "City of Philadelphia".................................                                  9.   9999999
   OVERPAYMENT OPTIONS    If Line 6C is greater than Line 5, enter the amount to be:
   10a.  Refunded.    Do not file a separate Refund Petition...........................................................                           10a. 9999999

   10b.  Applied to the 2020 Net Profits Tax Return................................................................................               10b. 9999999

   10c.  Applied to the 2021 Business Income & Receipts Tax...............................................................                        10c. 9999999

               Under penalties of perjury, as set forth in 18 PA C.S. §§ 4902-4903 as amended, I swear that I have reviewed this return
               and accompanying statements and schedules, and to the best of my knowledge and belief, they are true and complete.
   Taxpayer Signature________________________________________  Date_______________________Phone #_________________________

   Preparer Signature_________________________________________ Date_______________________Phone #_________________________

                                                                                                                                                  Vendor Name & Sumbission Date 
                                                                    BIRT-EZ Page 1



- 51 -
     2020 BIRT-EZ                                      31320                                                                                           City Account Number
     TAX COMPUTATION SCHEDULES                                                                                                                            7777777

If business is operated inside and outside of Philadelphia, you   must file the BIRT Regular return available at   www.phila.gov/revenue.
Reminder -   You   must use the same method (METHOD I or METHOD II) that you elected on the first Business Income & Receipts Tax return filed.
NET INCOME PORTION                                     Place "X" in box to indicate a loss.
                                                                                                                                                       
1.  METHOD II.  Net Income (or loss) as properly reported to the Federal Government.......................                                             1. X 999999999
                                         OR
2.  METHOD I.  Net Income (or loss) in accordance with Accounting System.......................................                                        2. X 999999999

3. Statutory Net Income Deduction from Worksheet S-EZ, Line S5, below...................................                                               3.   999999999

4. Loss Carry Forward, if any................................................................................................................          4.   999999999

5. Taxable Income or loss.  (Amount on Line 1 OR Line 2 minus Line 3 minus Line 4).......................                                              5. X 999999999

6.  TAX DUE (Line 5 X .0620).   If Line 5 is a loss, enter zero here and on Page 1, Line 1................                                             6.   999999999

GROSS RECEIPTS PORTION
                                                       Do not report negative numbers for gross receipts.
TAXABLE GROSS RECEIPTS from:
 7a.  Sales and/or rentals of tangible personal property..................................................................                         7a.      99999999999

7b.  Services.................................................................................................................................     7b.      99999999999

7c.  Rentals of real property...........................................................................................................           7c.      99999999999

7d.  Royalties..................................................................................................................................   7d.      99999999999

7e.  Gains on sales of capital business assets..............................................................................                       7e.      99999999999

7f.  Gains on sales of stocks, bonds, etc.  (Not applicable to individuals.).....................................                                  7f.      99999999999

7g.  Dividends.  (Not applicable to individuals.)..............................................................................                    7g.      99999999999

7h.  Interest.  (Not applicable to individuals.)..................................................................................                 7h.      99999999999

7i.  Other.  (Describe) ____________________________________________............................                                                   7i.      99999999999

8. TAXABLE GROSS RECEIPTS before Statutory Exclusion.  (Add Lines 7a through 7i.).........                                                         8.       99999999999

9. Statutory Exclusion (Lower of Line 8 or $100,000.00).........................................................                                   9.       99999999999

10. Net taxable Gross Receipts (Line 8 minus Line 9)..................................................................                             10.      99999999999

11.  TAX DUE.    (Line 10 X .001415).    Enter here and on Page 1, Line 2....................................                                      11.      99999999999

Worksheet S-EZ - Use to calculate Statutory Net Income Deduction
S1.  Enter the lower of Line 8 above or $100,000.00............................................................                                S1.          99999999999

S2.  Enter Net Income from Line 1 or Line 2.  If loss, enter zero..........................................                                    S2.          99999999999

S3.  Enter Taxable Gross Receipts from Line 8 above.........................................................                                   S3.          99999999999

S4.  Divide Line S2 by Line S3.  (Cannot be greater than 1.0000)........................................                                       S4.               9.9999

S5.  Statutory Net Income Deduction (Line S1 times Line S4.  Cannot exceed $100,000)...                                                        S5.          99999999999
       Enter here and on Line 3, above.
                                                       BIRT-EZ Page 2
                                                                                                                                                   Vendor Name & Sumbission Date 



- 52 -
         Philadelphia Scan Line Data 
 
         2020 BIRT Extension Payment Coupon 
 
 Field # Description 
 
 1 – 3   Always “333” 
 
 4 – 5   Type Tax -  24
 
 6 – 11  Due Date - 041521 
 
 12 – 19 Zero filled 
 
 20 – 26 Business Tax Account Number 
 
 27 – 49 Zero filled 
 
 50 – 53 Period / Year - 1320 
 
 54 – 67 Zero filled 
 
 68      Check Digit (Reference Page 7) 

                     52 



- 53 -
         Philadelphia Scan Line Data 
 
         2020 BIRT Payment Coupon 
 
 Field # Description 
 
 1 – 3   Always “333” 
 
 4 – 5   Type Tax -  24
 
 6 – 11  Due Date - 041521 
 
 12 – 19 Zero filled 
 
 20 – 26 Business Tax Account Number 
 
 27 – 49 Zero filled 
 
 50 – 53 Period / Year - 1220 
 
 54 – 67 Zero filled 
 
 68      Check Digit (Reference Page 7) 

                     53 



- 54 -
                        2020 BIRT and BIRT-EZ EXTENSION WORKSHEET and PAYMENT COUPONS 

This is an extension worksheet to be used when figuring the amount of Business Income & Receipts Tax you owe. You must file an actual return by the 
extension due date to satisfy your filing requirements.  Retain this worksheet for your records. 
If  an  extension  of  time  has  been  obtained  from  the  Internal  Revenue  Service  for  filing  your  corporate,  partnership  or  individual  tax  returns,  the 
corresponding returns are due on or before the due date of the federal extension(s) or 6/20/2021, whichever is later. You must pay 100% of the estimated 
tax due by April 15, 2021. Filing an extension coupon does not extend the time to pay the tax. Interest and penalty shall be added to the amount of tax not 
paid  by  the  statutory  due  date.  You  will  not  receive  written  confirmation  of  your  extension  request.  NOTE:  If  you  have  filed  for  an  automatic  federal 
extension but do not believe you will owe any tax, you do not need to file an extension coupon. 

    1. 100% of estimated 2019 Business Income & Receipts tax due .................................................................... 1                                 9999999 .00 

    2. Mandatory 2020 Business Income & Receipts estimated payment (repeat Line 1). .................................. 2                                                9999999 .00 

    3. Total Tax Due  (Line 1 plus Line 2) .......................................................................................................................... 3 9999999 .00 

    4. Other payments and credits you expect to report on the 2019 BIRT return ..................................................... 4                                  9999999 .00 
    5. Tax Balance Due (Line 3 minus Line 4).  Enter on the Extension Coupon. 
       If Line 4 is greater than Line 3, no extension coupon is needed. .................................................................... 5                          9999999 .00 
                                                                      Detach here
----------------------------------------------------------------------------------------------------------------------------------------------- 
        2020 BIRT and MANDATORY ESTIMATED 2021 BIRT                                                     Due Date:  April 15, 2021 
                         EXTENSION PAYMENT COUPON 

TAXPAYER NAME        Name and address 
and ADDRESS          Name and address 
                     Name and address 
CITY ACCOUNT #: 
                     1234567 

                                                                                          Estimated Tax Due                                                             7777777 .00 

                                               Make check payable to:  "City of Philadelphia" 
                                               Include your Account Number on your check or money order. 

           33324041521000000001234567000000000000000000000001320000000000000005 

                                                                      Detach here 
----------------------------------------------------------------------------------------------------------------------------------------------- 
        2020 BIRT and MANDATORY ESTIMATED 2021 BIRT                                                     Due Date:  April 15, 2021 
                                     PAYMENT COUPON 

TAXPAYER NAME        Name and address 
and ADDRESS          Name and address                                                                       Tax Due                                                     7777777 .00 
                     Name and address 
CITY ACCOUNT #:      1234567                                                                     Interest & Penalty                                                     7777777 .00 

                                                                                                        Total Due                                                       7777777 .00 

                                               Make check payable to:  "City of Philadelphia" 
                                               Include your Account Number on your check or money order. 

           33324041521000000001234567000000000000000000000001220000000000000007 

                                                                          54 



- 55 -
                                    2020 Net Profits Tax 
                                    Form ID Barcode: 31420 
                                    Barcode Type: Code 3 of 9 
 Top Barcode X/Y Position:          38/4       Bottom Barcode X/Y Position:          56/64 
 Top Barcode Narrow Bar Width:      17 mils    Bottom Barcode Narrow Bar Width:      20 mils 
 Top Barcode Narrow to Width Ratio: 2.5        Bottom Barcode Narrow to Width Ratio: 3.0 
 
 Field                                   # of chars.          X/Y Start Position 
 
 Top Left Reg. Mark                                           7/5 
 Top Right Reg. Mark                                          80/5 
 Bottom Left Reg. Mark                                        7/64 
 Bottom Right Reg. Mark                                       80/64 
 
 Name & Address Line 1                      40                8/11 to 47/11 
 Name & Address Line 2                      40                8/12 to 47/12 
 Name & Address Line 3                      40                8/13 to 47/13 
 Name & Address Line 4                      40                8/14 to 47/14 
 Name & Address Line 5                      40                8/15 to 47/15 
 
 E-mail Address                             30                52/16 to 81/16 
 Change of Address Box                      1                 33/17 to 33/17 
 
 City Account Number                        7                 64/9   to 70/9 
 Federal Identification Number              9                 63/11 to 71/11 
 Social Security Number                     9                 63/13 to 71/13 
 
 Percentage                                 3                 74/18 to 76/18 
 Amended Return Check Mark                  1                 33/19 to 33/19 
 Termination Date                           10                67/20 to 76/20 
 
 Line 1 Check Box                           1                 66/24 to 66/24 
 Line 1                                     7                 71/24 to 77/24 
 Line 2                                     7                 71/25 to 77/26 
 Line 3 Check Box                           1                 66/27 to 66/27 
 Line 3                                     7                 71/27 to 77/27 
 Line 4                                     7                 71/28 to 77/28 
 Line 5                                     7                 71/29 to 77/29 
 Line 6 Check Box                           1                 66/31 to 66/31 
 Line 6                                     7                 71/31 to 77/31 
 Line 7                                     7                 71/32 to 77/32 
 Line 8 Check Box                           1                 66/34 to 66/34 
 Line 8                                     7                 71/34 to 77/34 
 Line 9                                     7                 71/35 to 77/35 
 Line 10                                    7                 71/36 to 77/36 
 Line 11                                    7                 71/38 to 77/38 
 Line 12a                                   7                 71/40 to 77/40 
 Line 12b                                   7                 71/41 to 77/41 
 Line 12c                                   7                 71/42 to 77/42 
 Line 13                                    7                 71/44 to 77/44 
 Line 14                                    7                 71/45 to 77/45 
 Line 15                                    7                 71/47 to 77/47 
 Line 16                                    7                 71/49 to 77/49 
 Line 17                                    7                 71/51 to 77/51 
 Line 18                                    7                 71/52 to 77/52 
 Line 19a                                   7                 71/54 to 77/54 
 Line 19b                                   7                 71/55 to 77/55 
 Line 19c                                   7                 71/56 to 77/56 

                                            55 



- 56 -
                                                                                                                                                           2020 NPT
                   CITY OF PHILADELPHIA                    31420                                DUE DATE:  APRIL 15, 2021
     2020 NET PROFITS TAX
     CORPORATIONS ARE NOT SUBJECT TO THIS TAX                                                                                                              City Account Number
PROOF OF PRO RATA SHARE MUST BE ATTACHED (if applicable)                                                                                                   7777777

Name and address..................Line 1                                                        EIN                                                        999999999
Name and address..................Line 2
Name and address..................Line 3                                                        SSN                                                        999999999
Name and address..................Line 4
Name and address..................Line 5                                                        Taxpayer E-mail Address
                                                                                 aaaaaaaaaaaaaaaaaaaaaaaaaa.ddd
If this is a change of address, check this box:       X
and file a Change Form.                                              Percentage from Page 3, Worksheet D, Line 3, if applicable:                                              99%
If this is an amended return place an "X" here:       X
     If your business terminated in 2020, enter the termination date AND file a CHANGE FORM.                                                                    mm-dd-yyyy
                                                                                                
IF YOU ARE NOT ELIGIBLE FOR PA 40 SCHEDULE SP, YOU ARE NOT ELIGIBLE FOR
INCOME-BASED TAXATION AND ARE NOT ELIGIBLE FOR LINES 3-4 OR LINES 8-9.
1. Pro Rata Resident taxable income/loss   NOT eligible   for Income Based Rate
 from Page 2, Worksheet A, Line 5......................................................................................................................    1.   X 9999999
2. Line 1 X .038712.    If Line 1 is a loss, enter "0"...............................................................................................      2.     9999999
3. Pro Rata Resident taxable income/loss   eligible   for Income Based Rate
 from Page 2, Worksheet A, Line 6.....................................................................................................................     3.   X 9999999
4. Line 3 X .01500.    If Line 3 is a loss, enter "0"................................................................................................      4.     9999999
5. Total Resident Tax Due  (Line 2 plus Line 4)......................................................................................................      5.     9999999
6. Pro Rata Non-Resident taxable income/loss   NOT eligible for Income Based Rate
 from Page 2, Worksheet B, Line 7.....................................................................................................................     6.   X 9999999
7. Line 6 X .035019.    If Line 6 is a loss, enter "0"................................................................................................     7.     9999999
8. Pro Rata Non-Resident taxable income/loss   eligible for Income Based Rate
 from Page 2, Worksheet B, Line 8.....................................................................................................................     8.   X 9999999
9. Line 8 X .01500.    If Line 8 is a loss, enter "0"................................................................................................      9.     9999999
10. Total Non-Resident Tax Due  (Line 7 plus Line 9).............................................................................................          10.    9999999

11. Total Tax Due (Line 5 plus Line 10)..................................................................................................................  11.    9999999

 12a.  60% BIRT credit from Page 3, Worksheet K, Line 4 or Worksheet D, Line 8...................................................                          12a.   9999999
 12b.  Estimated payments and other credits from Page 3, Worksheet E, Line 4......................................................                         12b.   9999999
 12c.  Total payments and credits.  (Line 12a plus Line 12b).....................................................................................          12c.   9999999

13. Net Tax Due: (Line 11 less Line 12c.  If less than 0 enter the difference on Line 16)......................................... 13.                            9999999
14. Interest and Penalty.  Refer to web site for current percentage.........................................................................               14.    9999999
15.  TOTAL DUE including Interest and Penalty (Line 13 plus Line 14).
    Use payment coupon.  Make check payable to:  "City of Philadelphia"......................................................                              15.    9999999

16. Tax Overpaid.  If Line 12c is greater than Line 11, enter difference here............................................................                  16.    9999999
17. Enter 50% of Page 2, Worksheet C, Line 3.
   Do not use this line to remit estimated payments.........................................................................................               17.    9999999
18. Balance Available.  Line 16 minus Line 17.  If greater than 0 proceed to Overpayment Options................ 18.                                              9999999
OVERPAYMENT OPTIONS  Only available if Line 18 is greater than 0.  Enter the amount to be:
19a.  Refunded.    Do not file a separate Refund Petition.......................................................................................           19a.   9999999
19b.  Applied, up to the tax due, to the 2020 Business Income & Receipts Tax Return............................................ 19b.                              9999999
19c.  Applied to the 2021 Net Profits Tax................................................................................................................. 19c.   9999999

     Under penalties of perjury, as set forth in 18 PA C.S. §§ 4902-4903 as amended, I swear that I have reviewed this return
     and accompanying statements and schedules, and to the best of my knowledge and belief, they are true and complete.
Taxpayer Signature________________________________________  Date_______________________Phone #_________________________

Preparer Signature_________________________________________ Date_______________________Phone #_________________________
                                                                                                Vendor Name & Sumbission Date 
                                                           NPT Page 1



- 57 -
             WORKSHEETS A, B and C                                         These are worksheets only.
   2020 NET PROFITS TAX RETURN                                             Do not file these worksheets with your return.

                                                   Instructions for Worksheets A and B
Enter on Line 1 the net income or loss from the appropriate Federal Tax return(s) or if applicable, the Profit and Loss Statement.
Examples of Line 2 adjustments (not all inclusive):  Federal Form 1040, Schedule "C" filers - add back to net income any taxes based on net income which
have been deducted in arriving at reported net income, e.g., prior year Net Profits Tax   (the Business Income & Receipts Tax paid is deductible).   
Federal Form 1065 filers - add back to net income any taxes based on net income, capital gains, and guaranteed payments to partners; deduct from net
income IRC section 179 expense.  Nonresidents may take an income exclusion for Public Law 86-272 activity.

                                     WORKSHEET A:  Business Income (Loss) for Residents

1. Net Income (Loss)................................................................................................................................. 1.                             .00

2. Federal Form 1065, Schedule K-1 and other adjustments.....................................................................                         2.                             .00

3. Other taxable income............................................................................................................................   3.                             .00

4. Taxable Resident Net Income (Loss).  Add Lines 1 through 3..............................................................                           4.                             .00
5. Taxable Pro Rata Resident portion of Net Income/Loss   NOT eligible for Income-based rate.
   Enter here and on Page 1, Line 1.........................................................................................................          5.                             .00
6. Taxable Pro Rata Resident portion of Net Income/Loss   eligible for Income-based rate.
                                                                                                                                                      6.
   Enter here and on Page 1, Line 3.........................................................................................................                                         .00

                                     WORKSHEET B:  Business Income (Loss) for Nonresidents
Nonresidents of Philadelphia may apportion all or part of their net income to their places of business located outside of Philadelphia on Line 5, using
Worksheet NR-3 on Page 4.  The apportionment is based on a   three factor formula consisting of an average of the property owned, the salaries and
wages paid, and the receipts earned during the tax year.
1. Net Income (Loss)................................................................................................................................  1.                             .00

2. Federal Form 1065, Schedule K-1 and other adjustments...................................................................                           2.                             .00

3. Other taxable income...........................................................................................................................    3.                             .00

4. Total Net Income (Loss).   Add Lines 1 through 3................................................................................                   4.                             .00

5. Philadelphia apportionment factor from Page 4, Worksheet NR-3, Line 12..........................................                                   5. .

6. Taxable Nonresident Net Income (Loss). (Line 4 times Line 5)............................................................                           6.                             .00
7. Taxable Pro Rata Nonresident portion of Net Income/Loss   NOT eligible for Income-based rate.
   Enter here and on Page 1, Line 6.........................................................................................................          7.                             .00
8. Taxable Pro Rata Nonresident portion of Net Income/Loss   eligible for Income-based rate.
   Enter here and on Page 1, Line 8.........................................................................................................          8.                             .00

                                     WORKSHEET C:  Computation of Estimated Tax Base
If the amount on Line 3 is $100 or less, estimated payments are not required.  If the amount on Line 3 is greater than $100, enter 25% of the amount on 
the first and second estimated coupon. If Net Profits Tax estimated payments are required, there are two payments due.  The first estimated tax payment 
is due April 15, 202 1and the second estimated tax payment is due June 17, 202 .    1 Estimated tax payments are not required on September 15, 2021 
or January 15, 2022.

1. Net Profits Tax Liability from Page 1, Line 11........................................................................................             1.                             .00

2. Business Income & Receipts Tax Credit from Page 1, Line 12a or Page 3, Worksheet D, Line 8......... 2.                                                                            .00
3. Estimated Payments Base (Line 1 minus Line 2)
   If Line 2 is greater than Line 1, no Estimate coupon is needed.............................................................                        3.                             .00

                                                                                                                                                          2020 NPT Worksheets P2 09-29-2020
                                                                       Page 2



- 58 -
WORKSHEETS D, E, K and EXTENSION                  These are worksheets only.
     2020 NET PROFITS TAX RETURN                  Do not file these worksheets with your return.

WORKSHEET  D:    ALLOCATION  OF  BUSINESS  INCOME  &  RECEIPTS  TAX  CREDIT  FOR  PARTNERSHIPS,  ETC.,  WITH
CORPORATE MEMBERS (THIS SCHEDULE IS TO BE USED ONLY BY PARTNERSHIPS, JOINT VENTURES AND ASSOCIATIONS
WHICH  ARE  COMPOSED  OF  ONE  OR  MORE  CORPORATE  PARTNERS,  CORPORATE  JOINT  VENTURES,  OR  CORPORATE
ASSOCIATES.)

1. Enter the portion of taxable income on which 2020 Business Income & Receipts Tax has been paid,
   AND which represents the distributive shares of net income of ALL CORPORATE MEMBERS...........                                                         1.                        .00

2. Enter the total taxable income of the taxpayer on which 2020 BIRT has been paid...............................                                         2.                        .00

3. Divide Line 1 by Line 2 and enter the percentage here and on Page 1 of the return...............................                                       3.                             %

4. Enter the amount from Worksheet K, Line 2..........................................................................................                    4.                        .00

5. Multiply the amount on Line 4 by the percentage on Line 3....................................................................                          5.                        .00

6. Subtract Line 5 from Line 4...................................................................................................................         6.                        .00

7. Enter the amount from Page 1, Line 11.................................................................................................                 7.                        .00
8.  Business Income & Receipts Tax Credit allowed.  Enter the lesser of Line 6 or Line 7 here and on
   Page 1, Line 12a...................................................................................................................................    8.                        .00

                             WORKSHEET E:  Summary of Payments and Other Credits

1. 2020 Estimated Net Profits Tax Payments..............................................................................................                  1.                        .00

2. Payments of 2020 Net Profits Tax made with Application for Extension of Time to File........................                                           2.                        .00
3. Overpayment of 2020 Business Income & Receipts Tax or 2019 Net Profits Tax
   to be applied to this return......................................................................................................................     3.                        .00

4. TOTAL of Lines 1 through 3.  Enter here and on Page 1, Line 12b.........................................................                               4.                        .00

                             WORKSHEET K:  60% Business Income and Receipts Tax Credit
1. Enter the amount from Page 1, Line 1 of the 2020 Business Income & Receipts Tax or
   BIRT-EZ return........................................................................................................................................ 1.                        .00
2. Enter 60% of the amount on Line 1.  If your entity has corporate members,   STOP HERE and
   enter this amount on Worksheet D, Line 4..............................................................................................                 2.                        .00

3. Enter the amount from Page 1, Line 11 of the 2020 Net Profits Tax return............................................                                   3.                        .00
4. Business Income & Receipts Tax credit allowed.  Enter the lesser of Line 2 or Line 3 here and
   on Page 1, Line 12a................................................................................................................................    4.                        .00

                                                  EXTENSION WORKSHEET

This is an extension worksheet to be used when figuring the amount of Net Profits tax you owe.  You must file an actual return by the extension due date 
to satisfy your filing requirements.  If an extension of time has been obtained from the Internal Revenue Service for filing your corporate, partnership or 
individual tax returns, the corresponding returns are due on or before the due date of the federal extension(s).    You must pay 100% of the estimated 
tax due by April 15, 2021.   Filing an extension coupon does   not extend the time to pay the tax.  Interest and penalty shall be added to the amount 
of tax not paid by the statutory due date.  You will not receive written confirmation of your extension request.   NOTE:  If you have filed for an automatic 
federal extension but do not believe you will owe any tax, you do not need to file an extension coupon.

1. 100% of estimated 2020 NET PROFITS tax due....................................................................................                         1.                        .00

2. Other payments and credits you expect to report on the NPT return......................................................                                2.                        .00
3.  Tax Balance Due (Line 1 minus Line 2).    Enter on the Extension Coupon.
     If Line 2 is greater than Line 1, no extension coupon is needed.............................................................                         3.                        .00

                                                                                                                                                             2020 NPT Worksheets P3 09-29-2020
                                                  Page 3



- 59 -
       WORKSHEET NR-3                              Computation of apportionment factors to be applied to apportionable
2020 NET PROFITS TAX RETURN                        net income of certain   nonresidents of Philadelphia.

Calculation of Average Values of Real and Tangible Property Used in Business:
                                                                                                        COLUMN A                                                    COLUMN B
                                                                                                        PHILADELPHIA                                            TOTAL EVERYWHERE

1. Inventories of Raw Materials, Work in Process and Finished Goods...................               1.

2. Land and Buildings Owned (at average original cost)..........................................     2.

3. Machinery and Equipment Owned (at average original cost)...............................           3.

4. Other Tangible Assets Owned (at average original cost)...................................... 4.

5. Rented Property (at 8 times the net annual rental)............................................... 5.

6. Total average value of Property used   WITHIN PHILADELPHIA..........................              6.                                                     XXXXXXXXXX

7. Total average value of Property used   EVERYWHERE........................................         7. XXXXXXXXXX

Computation of Apportionment Factors:
8A.  Total average value of Philadelphia property from Column A, Line 6 above......................................... 8A.                                                        .00

8B.  Total average value of property everywhere from Column B, Line 7 above......................................... 8B.                                                          .00

8C.  Philadelphia property factor (Line 8A divided by Line 8B)...................................................................                     8C.  .

9A.  Philadelphia Payroll............................................................................................................................ 9A.                         .00

9B.  Payroll Everywhere.............................................................................................................................  9B.                         .00

9C.  Philadelphia payroll factor (Line 9A divided by Line 9B)......................................................................                   9C.  .

10A.  Philadelphia receipts before BIRT Statutory Exclusion.....................................................................                      10A.                        .00

10B.  Gross receipts everywhere...............................................................................................................        10B.                        .00

10C.  Philadelphia receipts factor (Line 10A divided by Line 10B).............................................................                        10C. .

11. TOTAL FACTORS (Total of Lines 8C, 9C and 10C)...........................................................................                          11.  .

12. Philadelphia apportionment factor (Line 11 divided by applicable number of factors)........................... 12.                                     .
Enter factor here and on Page 2, Worksheet B, Line 5.

                                    Allocation versus Apportionment of a Nonresident's Net Profits

A  nonresident  individual,  partnership,  association  or  other  unincorporated  entity  conducting  or  carrying  on  any  business,  profession,
trade, enterprise or other activity is required to pay the Net Profits Tax (NPT) on the entire net profits of the business if     activityall                                     is
conducted within the City of Philadelphia.  This is true despite the absence of a Philadelphia office or business location.

Where a nonresident maintains   both Philadelphia and non-Philadelphia branch offices, the taxpayer   may allocate net profits between or
among the Philadelphia and non-Philadelphia branch locations.  The taxpayer must be prepared to show the Revenue Department that
each branch office or location is self-sustaining and established.  This is a question of fact, depending on the particular circumstances in
each case.  One factor (of many) used by the Department to support a branch office is the presence of separate branch accounting
books and records to support the allocation of the net profits between or among the various branch offices.  In the absence of separate
accounting records, the nonresident taxpayer   must apportion their net profits using the three-factor apportionment formula.    Refer to
Income Tax Regulation 222 at   www.phila.gov/revenue.

                                                                                                                                                           2020 NPT Worksheets P4 09-29-2020
                                                               Page 4



- 60 -
         Philadelphia Scan Line Data 
 
         2020 Net Profit Extension Coupon 
 
 Field # Description 
 
 1 – 3   Always “333” 
 
 4 – 5   Type Tax -  03
 
 6 – 11  Due Date - 041521 
 
 12 – 19 Zero filled 
 
 20 – 26 Business Tax Account Number 
 
 27 – 49 Zero filled 
 
 50 – 53 Period / Year – 1320 
 
 54 – 67 Zero filled 
 
 68      Check Digit (Reference Page 7) 

                     60 



- 61 -
         Philadelphia Scan Line Data 
 
         2020 Net Profit Payment Coupon 
 
 Field # Description 
 
 1 – 3   Always “333” 
 
 4 – 5   Type Tax -  03
 
 6 – 11  Due Date - 041521 
 
 12 – 19 Zero filled 
 
 20 – 26 Business Tax Account Number 
 
 27 – 49 Zero filled 
 
 50 – 53 Period / Year - 1220 
 
 54 – 67 Zero filled 
 
 68      Check Digit (Reference Page 7) 

                     61 



- 62 -
                                      Detach here
 ----------------------------------------------------------------------------------------------------------------------------------------------- 
                 2020 NET PROFITS TAX                                      Due Date April 15, 2021 
  EXTENSION PAYMENT COUPON 
 
 TAXPAYER NAME   Name and address 
 and ADDRESS     Name and address 
                 Name and address 
 CITY ACCOUNT #: 1234567 
 
                                                  (1) Estimated Tax Due               9999999      .00 
 
                            Make check payable to:  "City of Philadelphia" 
                            Include your Account Number on your check or money order. 
 
             33303041521000000001234567000000000000000000000001320000000000000009 
 
                                      Detach here 
 ----------------------------------------------------------------------------------------------------------------------------------------------- 
  2020 NET PROFITS TAX                                                     Due Date April 15, 2021 
             PAYMENT COUPON 
                                          
 TAXPAYER NAME   Name and address 
 and ADDRESS     Name and address         
                 Name and address         
 CITY ACCOUNT #: 1234567                  

                                                  (1) Total Due from Page 1, Line 15  9999999      .00 
 
                            Make check payable to:  "City of Philadelphia" 
                            Include your Account Number on your check or money order. 
 
             33303041521000000001234567000000000000000000000001220000000000000001 
 
                                      62 



- 63 -
         Philadelphia Scan Line Data 
 
         2020 Net Profit - 1st Estimate Payment Coupon 
 
 Field # Description 
 
 1 – 3   Always “333” 
 
 4 – 5   Type Tax -  03
 
 6 – 11  Due Date - 041521 
 
 12 – 19 Zero filled 
 
 20 – 26 Business Tax Account Number 
 
 27 – 49 Zero filled 
 
 50 – 53 Period / Year - 0121 
 
 54 – 67 Zero filled 
 
 68      Check Digit (Reference Page 7) 

                     63 



- 64 -
         Philadelphia Scan Line Data 
 
         2020 Net Profit - 2nd Estimate Payment Coupon 
 
 Field # Description 
 
 1 – 3   Always “333” 
 
 4 – 5   Type Tax -  03
 
 6 – 11  Due Date - 061521 
 
 12 – 19 Zero filled 
 
 20 – 26 Business Tax Account Number 
 
 27 – 49 Zero filled 
 
 50 – 53 Period / Year - 0221 
 
 54 – 67 Zero filled 
 
 68      Check Digit (Reference Page 7) 

                     64 



- 65 -
                                   Detach here 
 ---------------------------------------------------------------------------------------------------------------------------------------------- 
             2021 NET PROFITS TAX                                         Due Date:  April 15, 2021 
     1st ESTIMATED PAYMENT COUPON 

 TAXPAYER NAME    Name and address 
                                                (1)  Enter 25% of amount 
 and ADDRESS      Name and address              from Worksheet C, Line 3                     7777777  .00 
                                                                                             
                  Name and address 
 CITY ACCOUNT #:  1234567                       (2)  Tax Overpaid                            7777777  .00 
                                                from NPT Page 1, Line16 
                                                (3)  First estimate of 2020                  7777777  .00 
                                                NPT (Line 1 minus Line 2) 
 
                           Make check payable to:  "City of Philadelphia" 
                           Include your Account Number on your check or money order. 
 
     33303041521000000001234567000000000000000000000000121000000000000002 
 
                                   Detach here
 ---------------------------------------------------------------------------------------------------------------------------------------------- 
              2021 NET PROFITS TAX                                        Due Date June 15, 2021 
     2nd ESTIMATED PAYMENT COUPON 
 
 TAXPAYER NAME    Name and address                                                                   
                                                (1
 and ADDRESS      Name and address                  )EnterWorksheet25% ofC,amountLine 3from           .00 
                                                                                             7777777
                  Name and address               
                                                (2
 CITY ACCOUNT #:  1234567                         )  Tax Overpaid                                     .00 
                                                     from from ENP-1                         7777777  
                                                
                                                (3)  Second estimate of 2020 NPT                      .00 
                                                     (Line 1 minus Line 2)                   7777777 
 
                           Make check payable to:  "City of Philadelphia" 
                           Include your Account Number on your check or money order. 
 
     33303061521000000001234567000000000000000000000000221000000000000001 
 
                                    65 



- 66 -
                          2020 No Tax Liability Business Income Receipt Tax
                                   Form Barcode Number: 31720 
                                        Barcode Type: Code 3 of 9 
Top Barcode X/Y Position:          38/4         Bottom Barcode X/Y Position:          56/64 
Top Barcode Narrow Bar Width:      17 mils      Bottom Barcode Narrow Bar Width:      20 mils 
Top Barcode Narrow to Width Ratio:  2.5         Bottom Barcode Narrow to Width Ratio: 3.0 

Variable Field                             # of chars.            X/Y Position 

Top Left Reg. Mark                                                7/5 
Top Right Reg. Mark                                               80/5 
Bottom Left Reg. Mark                                             7/64 
Bottom Right Reg. Mark                                            80/64 

Name & Address Line 1                      40                     8/11    to  47/11 
Name & Address Line 2                      40                     8/12    to  47/12 
Name & Address Line 3                      40                     8/13    to  47/13 
Name & Address Line 4                      40                     8/14    to  47/14 
Name & Address Line 5                      40                     8/15    to  47/15 
E-mail Address                             30                     51/16 to 80/16 
Change of Address Box                      1                      45/17 to  45/17 

City Account Number                        7                      63/9   to 69/9 
Federal Identification Number              9                      62/11 to 70/11 
Social Security Number                     9                      62/13 to 70/13 

Termination Date                           10                     61/19 to 70/19  

                                           48 



- 67 -
                                                             31720                           2020 BIR NTL
                  CITY OF PHILADELPHIA                                                       DUE DATE:  APRIL 15, 2021
                  DEPARTMENT OF REVENUE
        2020 BUSINESS INCOME & RECEIPTS TAX                                                      City Account Number
        For business conducted 100% in Philadelphia                                              7777777

   Name and address..................Line 1                                                  EIN 999999999
   Name and address..................Line 2
   Name and address..................Line 3                                                  SSN 999999999
   Name and address..................Line 4
   Name and address..................Line 5                                                  Taxpayer E-mail Address
                                                                                      aaaaaaaaaaaaaaaaaaaaaaaaaa.ddd
If this is a change of address, file a Change Form and check this box:       X

If your business terminated in 2020, enter the termination date   AND   file a CHANGE FORM.      mm-dd-yyyy
                                                                                            

          Instructions
          Philadelphia’s Business Income and Receipts Tax (BIRT) return includes a taxable gross receipts exclusion of $100,000.
          Beginning with tax year 2020, a taxpayer who has Philadelphia taxable gross receipts of $100,000 or less –and as a
          result, owes no BIRT– is not required to file this return.

          If you have Philadelphia gross taxable receipts of $100,000 or less, and you choose not to file the BIRT return, please
          complete this No Tax Liability (NTL) form by completeing the taxpayer information above and signing below.

          By doing so, you will avoid any non-filer issues.  This NTL form allows you and the Department of Revenue to maintain
          consistent records of tax compliance.

          Even if you don’t owe BIRT this year, and choose not to file a return,   you may still owe Net Profits Tax (NPT).  You may
          choose to file a BIRT return when you have a loss to report, even when there is no obligation to file a return.  Whether or
          not you file a return, you must maintain records in the event of an audit, and to carryforward any net operating loss to a
          future year.  An NTL form does not record net operating losses from year to year. Please consult your tax professional or
          visit   www.phila.gov/revenue for more information.

          Under penalties of perjury, as set forth in 18 PA C.S. §§ 4902-4903 as amended, I swear that I have reviewed this return
          and accompanying statements and schedules, and to the best of my knowledge and belief, they are true and complete.
   Taxpayer Signature________________________________________  Date_______________________Phone #_________________________

   Preparer Signature_________________________________________ Date_______________________Phone #_________________________

                                                                                             Vendor Name / Sumbission Date 00-00-2020
                                                                    NTL Page 1






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