ISP 2023                           INSTITUTION AND SERVICE PRIVILEGE TAX 
                                            CITY OF PITTSBURGH 
                                                                                                      Rev 11/22   
    ACCOUNT NO                       FEDERAL ID             Amended Return (  )    

       ANNUAL                             00                SIGNATURE _____________________________________________ 
       CITY ID                                              TITLE _____________________ DATE _______________________ 
 DUE ON OR BEFORE  APRIL 15, 2023 
                                                            PHONE _________________________________________________ 

 Business Name:                                             E-MAIL ADDRESS ________________________________________ 
                                                            PREPARER’S NAME ______________________________________ 
 Mailing Address:
                                                            PREPARER’S PHONE ______________________________________ 
                                                            I hereby certify, swear and aver that all statements herein are true and correct to the best of my knowledge and 
 City, State, Zip:                                          belief, being duly apprised of my duty under the law to submit honest and complete information or be subject to the 
                                                            penalties provided by law. 
                                                            OMISSION OF THE ABOVE APPLICABLE INFORMATION 
                                                                  CONSTITUTES AN INCOMPLETE RETURN 

USE BLACK INK ONLY ON THIS FORM- DO NOT STAPLE ANYTHING TO THIS FORM 
*IRS Form 990-T must be included with this Return. An “Institution of Purely Public Charity” (see, 10 P.S. Sec. 376) must include proof of
exemption: PA sales tax exemption number - ______________________or other evidence proving status as Institution of Purely Public Charity.

                                            COMPUTATION OF TAX
                    A. GROSS           B. EXEMPTIONS &      C. NET TAXABLE                            D. NET TAX
    CATEGORY        REVENUE                 EXCLUSIONS*           REVENUE                TAX RATE  AMOUNT DUE 
                    1A.                1B. Total Exemption  1C. (Subtract 1B from 1A)                 1D.
 1.SERVICES                            Amount  
                                                                                         1C X 0.006 = 
                    $____________      $___________________ $__________________                       $_____________ 
                                        2B. 
                    2A.                     Total Exemption 2C. (Subtract 2B from 2A)                 2D. 
 2.COMMISSIONS                         Amount  
                                                                                         2C X 0.006 = 
                    $____________      $_____________________  $__________________                    $_____________ 
                                       3B. 
                    3A.                    Total Exemption  3C. (Subtract 3B from 3A)                 3D. 
                                       Amount   
 3. RENTALS                                                                              3C X 0.006 = 
                    $____________      $_____________________  $__________________                    $_____________ 
                                       4B. 
 4. GOODS,          4A.                    Total Exemption  4C. (Subtract 4B from 4A)                 4D. 
                                       Amount  
    WARES                                                                                4C X 0.002 = 
 & MERCH. SOLD      $____________      $_____________________  $__________________                    $_____________ 
                                       5B. Total Exemption  5C. (Subtract 5B from 5A)                 5D. 
    5. OTHER        5A.                Amount   
 (Specify below)                                                                         5C X 0.006 = 
 __________________                    $_____________________  $__________________                    $_____________ 
                    $__________
     
 *Enter in the Total Exemption/Exclusion amount (lines 1B- 5B) from the Exemption & Exclusions Worksheet on Page 2, if any.
 6. REVENUES REPORTED ON FORM 990-T that are not subject to tax and not                  6. _________________._____
    otherwise excluded in Box B entries above.  (Include IRS status – IRC Sec. 501(c)___)
 7. TOTAL NET TAX DUE   (add lines 1D through 5D)                                        7. _________________._____
 8. INTEREST   (1% (0.01) per month)                                                     8. _________________._____
 9. PENALTY   (0.5% (0.005) per month)                                                   9. _________________._____
 10. TOTAL AMOUNT DUE (add lines 6 through 9)                                            10. ___________________._____

 ${0004}_${0007} 

 070000000000000000000000000002023 

                   EXEMPTION & EXCLUSIONS WORKSHEET                                                    
                                                                                                         
      CATEGORY    B. EXEMPTION & EXCLUSIONS                                                            AMOUNT 
                                                                                                
                  I.City Ordinance #6 of 1996 Detailing Exemption on gross annual receipts 
                  is $20,000.                                                                   I.     $__________.___ 
                                                                                                        
                  II. Interstate Transaction (include itemized breakdown on separate page) 
                                                                                                II.    $__________.___ 
 1. SERVICES       
                  III.Receipts not attributable and not allocable to a Pittsburgh business      
                   (include breakdown) and list addresses                                       III.   $__________.___ 
                  IV. Other Exemption & Exclusions – Be specific – Attach additional sheets if        
                  necessary                                                                     IV.    $__________.___ 
                                                                                                
 LINE 1B ON PAGE 1- Add the amounts in lines 1B I- IV. above & enter total                     1B.   $__________________.____ 
                  I.City Ordinance #6 of 1996 Detailing Exemption on gross annual receipts              
                  is $20,000.                                                                   I.     $__________.___ 
                                                                                                        
                  II. Interstate Transaction (include itemized breakdown on separate page) 
 2.COMMISSIONS                                                                                  II.    $__________.___ 
                  III.Receipts not attributable and not allocable to a Pittsburgh business      
                   (include breakdown) and list addresses                                       III.   $__________.___ 
                  IV. Other Exemption & Exclusions – Be specific – Attach additional sheets if        
                  necessary                                                                     IV.    $__________.___ 
                                                                                                
 LINE 2B ON PAGE 1 - Add the amounts in lines 2B I- IV. above and enter total                  2B.   $__________________.____ 
                  I.City Ordinance #6 of 1996 Detailing Exemption on gross annual receipts              
                  is $20,000.                                                                   I.     $__________.___ 
                                                                                                        
                  II. Interstate Transaction (include itemized breakdown on separate page) 
 3.   RENTALS                                                                                   II.    $__________.___ 
                  III.Receipts not attributable and not allocable to a Pittsburgh business      
                   (include breakdown) and list addresses                                       III.   $__________.___ 
                  IV. Other Exemption & Exclusions – Be specific – Attach additional sheets if        
                  necessary                                                                     IV.    $__________.___ 
                                                                                                
 LINE 3B ON PAGE 1 - Add the amounts in lines 3B I- IV. above and enter total                  3B.   $__________________.____ 
                                                                                                        
                  I.City Ordinance #6 of 1996 Detailing Exemption on gross annual receipts      I.     $__________.___ 
                  is $20,000.                                                                           
                   
 4.  GOODS,       II. Interstate Transaction (include itemized breakdown on separate page)      II.    $__________.___ 
                                                                                                
    WARES         III.Receipts not attributable and not allocable to a Pittsburgh business      III.   $__________.___ 
    & MERCH. SOLD (include breakdown) and list addresses                                              
                   
                                                                                                IV.    $__________.___ 
                  IV.Manufacturing                                                                    
                   
                                                                                                V.     $__________.___ 
                  V.PA Sales Tax                                                                      
                  VI. Other Exemption & Exclusions – Be specific – Attach additional sheets if  VI.    $__________.___ 
                  necessary 
                                                                                                
 LINE 4B ON PAGE 1 - Add the amounts in lines 4B I- VI. above and enter total                  4B.   $__________________.____ 
                  I.City Ordinance #6 of 1996 Detailing Exemption on gross annual receipts 
                                                                                                I.     $__________.___ 
                  is $20,000.                                                                           
                   
                  II. Interstate Transaction (include itemized breakdown on separate page) 
 5.  OTHER                                                                                      II.    $__________.___ 
 (Specifiy below) III.Receipts not attributable and not allocable to a Pittsburgh business      
                  (include breakdown) and list addresses 
                                                                                                III.   $__________.___ 
 ________________ IV. Other Exemption & Exclusions – Be specific – Attach additional sheets if        
                  necessary                                                                     IV.    $__________.___ 
                                                                                                
 LINE 5B ON PAGE 1 - Add the amounts in lines 5B I- IV. above and enter total                  5B.   $__________________.____ 
      

                     City of Pittsburgh, Institution And Service Privilege Tax 
                                        City Code Title Two Chapter 247 
                                                                 
                                                   INSTRUCTIONS 
       
SECTION A- HOW TO REPORT GROSS REVENUE 
Gross Revenue should be entered in line 1A- 5A per business category. Example:  $500.00 for Services in 1A and 
$1,600.00 for Commissions in 2A.  If reporting revenue in 5A, explain the “Other” source of revenue in the space provided on 
page 1. 
 
NEW BUSINESSES:  
In the FIRST year of operation, indicate starting date here: __________/__________/__________ and first month’s gross 
revenue here: $ ___________________.  Multiply the first month’s gross revenue by the number of months, including any 
fraction thereof; from the starting date to December 31.  The product of this calculation (first month’s revenue multiplied by 
the number of months and fraction of a month from the starting date to December 31) is to be reported on page one.  
 
In the SECOND year of operation, calculate tax by multiplying the same first month’s volume of business by twelve (12).  
Enter the result of this calculation on page one.  
  
If the business is temporary or seasonal (less than sixty- (60) days’ duration), the actual gross revenue realized during the 
entire period of operation is to be reported on page one.  Such seasonal and temporary businesses are required to file this 
return within seven (7) days of the termination of the business or business activity. 
       
SECTION B- EXEMPTIONS AND EXCLUSIONS 
Enter in the total exemption amounts (lines 1B-5B) in from the Exemptions and Exclusion Worksheet (page2). Calculate 
the total exemptions/ exclusion in the worksheet for each category and enter the amount in Section B on page 1. The 
details of any exemptions or exclusions for purposes of calculating taxable gross revenue must be entered in this section.  
Include all necessary proof: documents, forms and schedules for your exemptions (if applicable), simply filling in the dollar 
amount is not adequate.  Failure to adequately explain an exemption or exclusion may result in a billing for additional tax.  
You must provide the addresses of those locations for which you are claiming an exemption or exclusion.  
       YOU MUST FILE AN INSTITUTION AND SERVICE PRIVILEGE TAX RETURN TO CLAIM EXEMPTION 
 
COMMON EXCLUSIONS: Any activity(ies) conducted by a non-profit organization in which unpaid volunteers conduct the 
activity(ies), the receipts go in their entirety to the organization. Also excluded are taxes collected, membership dues, 
voluntary or charitable contributions unrelated to specific services; any taxes collected as an agent for the United States of 
America, Commonwealth of Pennsylvania, or the City of Pittsburgh. 
 
CITY ORDINANCE #6 OF 1996 DETAILING EXEMPTION ON GROSS ANNUAL RECEIPTS:                    Every person or institution 
is entitled to ONE exemption from gross receipts.  If you file more than one Institution and Service Privilege Tax return, 
you may take the exemption against ONLY ONE of those return = $20,000.00 
 
SECTION C- NET REVENUE 
To calculate the net revenue, take the gross revenue per each category (1A-5A) minus the exemptions and exclusion per 
each category (1B-5B). For example, if the gross revenue for services was $500.00 (line 1A) and the exemption/exclusion 
amount was $100.00 (line 1B), the net revenue would equal $400.00 (line 1C).  
 
SECTION D- NET TAX AMOUNT DUE 
To calculate this section, take the net revenue amount multiplied by the corresponding tax rate. For example, if the net 
revenue for services was $400.00 you would take $400.00 X 0.006 = $2.40. $2.40 would be the net tax amount due. 
 
LINE 7- TOTAL NET TAX DUE -Add lines 1D – 5D to calculate the total net tax due.  
 
LINES 8- 11- After completing lines 1 through 11, remit a check made payable to: TREASURER, CITY OF PITTSBURGH on 
or before the return due date indicated on the top of the first page.  Make sure your City Account Number is on the check 
or money order.  Payments made after the due date must include penalty and interest amounts (lines 8 and 9).  Make sure 
you sign and date the return.  Failure to do so may cause a delay in processing. 
 

SPECIAL NOTICE: Internal  Revenue Service (IRS)  federal filing  information has been made  available to the City  of 
Pittsburgh, Finance Department, and may be used to compare tax returns. 
 
THIS RETURN MUST BE FILED  WITH  THE TREASURER, CITY OF PITTSBURGH, ON OR BEFORE THE DATE 
INDICATED, WITH REMITTANCE IN FULL FOR AMOUNT OF TAXES TO AVOID THE IMPOSITION OF PENALTY AND 
INTEREST.  FAILURE TO FILE  A COMPLETE AND TIMELY  RETURN MAY  RESULT IN LEGAL  ACTION BY THE 
TREASURER’S OFFICE.  Any forms that are received where the business is not registered and a registration form has 
not been included or where the tax form is filled out improperly, the tax form may be returned to the taxpayer.  Penalty and 
interest will accrue until the form is properly completed and returned. 
 
Pursuant to the Acts of Assembly No. 320 approved June 20, 1947, No. 374, approved May 12, 1949, No. 508, approved 
August 24, 1961, and No. 511, approved December 31, 1965, the City of Pittsburgh Home Rule Charter, the Pittsburgh 
Code and any and all amendments or subsequent re-enactment’s of any of the foregoing, this return is made of the total 
and taxable volume of business for the period indicated. 
 
The Pittsburgh Code imposes a tax rate of six mills (0.006) or two mills (0.002) depending on the type of revenue on each 
dollar of volume of the gross annual revenue of any foundation, partnership, association, corporation, s-corporation, any 
other type of organization operating under a non-profit organization or organized as a non-profit entity. Any type of service, 
income, rental, sale of drinks, food and dance activity conducted by the non-profit charter to the general public or to a 
selected or limited number thereof is taxable and due. 
 
FILING DEADLINE 
Annual filing due on or before April 15 of the current year, but is based on gross receipts received in the prior year. 
 
WHO IS TAXED ON GROSS INCOME 
Entities covered include hospitals, libraries, universities, colleges, “schools, other than secondary or elementary”, fraternal 
organizations and other  organizations  with status 501 (C)(3), nursing homes, veterans organizations, health 
organizations, charitable organizations and day care providers. 
 
WHO IS NOT TAXED ON GROSS INCOME 
Political subdivisions, any agent of Federal, State or Local government, a true public charity in respect to transactions 
directly related to its principal charitable purpose. 

  FOR ASSISTANCE WITH THIS FORM, PLEASE CALL 412-255-2525 
 
 Has business been sold or discontinued? Do you need to update or change your business 
 information? If YES, a CHANGE IN BUSINESS STATUS FORM must be completed and returned for 
 processing. Form(s) can be downloaded at www.pittsburghpa.gov/finance or call 412-255-2525 to 
 request the form. 
  
                                                      Make check payable to: 
                   TREASURER, CITY OF PITTSBURGH – DO NOT SEND CASH 
                    WRITE YOUR CITY ACCOUNT NUMBER ON YOUR CHECK 
  A $30.00 fee will be assessed for any check returned from the bank for any reason. 
                                                                 
                                                         MAIL TO: 
                                 CITY TREASURER ISP TAX 
                                                      414 GRANT ST STE 224 
                                 PITTSBURGH PA 15219-2476