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FORM 531 - FINAL EARNED INCOME TAX RETURN Attach all w-2's, 1099's and/or appropriate
CUMBERLAND COUNTY TAX BUREAU copies of State Schedules
PHONE: 717-590-7997
WEB SITE: www.cumberlandtax.org
CLGS-32-1 (04-16)
TAXPAYER ANNUAL
LOCAL EARNED INCOME TAX RETURN
You are entitled to receive a written explanation of your rights with regard to the audit, appeal, enforcement, refund and collection of local taxes. Contact your Tax Officer.
*If you have relocated during the tax year, please supply additional information. Tax Year
DATES LIVING AT EACH ADDRESS STREET ADDRESS (No PO Box, RD or RR) CITY OR POST OFFICE STATE ZIP
/ / TO / /
/ / TO / /
**If you need additional space - please see back of form.
Taxpayer A:
Taxpayer B:
TAXPAYER A: ONLINE PIN
TAXPAYER B: ONLINE PIN
DAYTIME PHONE NUMBER RESIDENT PSD CODE
EXTENSION AMENDED RETURN NON-RESIDENT
Taxpayer A Social Security # Taxpayer BSpouse’s()Social Security #
The calculations reported in the first column MUST pertain to the name printed
above on the left and the calculations in the second column should be for the
spouse name listed on the right. If you had NO EARNED INCOME, If you had NO EARNED INCOME,
Combining income is NOT permitted. check the reason why: check the reason why:
ONLY USE BLACK OR BLUE INK TO COMPLETE THIS FORM disabled student disabled student
deceased military deceased military
Single Married, Filing Jointly Married, Filing Separately Final Return* homemaker retired homemaker retired
unemployed unemployed
1. Gross Compensation as Reported on W-2(s). (Enclose W-2s) . . . . . . . . . . . . . .00 .00
2. Unreimbursed Employee Business Expenses. (Enclose PA Schedule UE) . . . . .00 .00
3. Other Taxable Earned Income * . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .00 .00
4. Total Taxable Earned Income (Subtract Line 2 from Line 1 and add Line 3) . . . . .00 .00
5. Net Profit (Enclose PA Schedules*) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .00 .00
NON-TAXABLE S-Corp earnings check this box:
6. Net Loss (Enclose PA Schedules*) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .00 .00
7. Total Taxable Net Profit (Subtract Line 6 from Line 5. If less than zero, enter zero) . . .00 .00
8. Total Taxable Earned Income and Net Profit (Add Lines 4 and 7) . . . . . . . . . . . . .00 .00
9. Total Tax Liability (Line 8 multiplied by ) . . . . . . . . . . . . . . . . .00 .00
10. Total Local Earned Income Tax Withheld (May not equal W-2 - See Instructions) .00 .00
11.Quarterly Estimated Payments/Credit From Previous Tax Year . . . . . . . . . . . .00 .00
12. Out-of-State, Philadelphia, Act 172 Credits (include supporting documentation) .00 .00
13. TOTAL PAYMENTS and CREDITS (Add Lines 10 through 12) . . . . . . . . . . . . .00 .00
14. Refund IF MORE THAN $1.00, enter amount (or select option in 15) . . . . . . . . .00 .00
15. Credit Taxpayer/Spouse (Amount of Line 13 you want as a credit to your account) . . . .00 .00
Credit to next year Credit to spouse
16. EARNED INCOME TAX BALANCE DUE (Line 9 minus Line 13). . . . . . . . . . . .00 .00
17. Penalty after April 15* (multiply Line 16 x 0.01 x # months u paid)n . . . . . . . . . . . .00 .00
18. Interest after April 15* (multiply Line 16 x 0.000082 x # days n u paid) . . . . . . . .00 .00
19. TOTAL PAYMENT DUE (Add Lines 16, 17, and 18) . . . . . . . . . . . . . . . . . . . . . .00 .00
*See Instructions
Under penalties of perjury, I (we) declare that I (we) have examined this information, including all accompanying
schedules and statements and to the best of my (our) belief, they are true, correct and complete.
YOUR SIGNATURE SPOUSE’S SIGNATURE (If Filing Jointly) DATE (MM/DD/YYYY)
PREPARER’S PRINTED NAME & SIGNATURE PHONE NUMBER
