1Gross compensation as reported on W-2(s) (enclose W-2s)
2Unreimbursed Employee Business Expenses (enclose PA Schedule UE)
3Other Taxable Earned Income (see Instructions; enclose supporting documents)
4Total Taxable Earned Income (subtract Line 2 from Line 1 and add Line 3)
5Net Profits (enclose PA Schedules)
NON-TAXABLE S-CORP earnings check this box (enclose S-Corp Schedule)
6Net Loss (enclose PA Schedules)
7Total Taxable Net Profit (subtract Line 6 from Line 5; if less than zero, enter zero)
8Total Taxable Earned income and Net Profit (add Line 4 and Line 7)
9Total Tax Liability (Line 8 multiplied by ____ . ____ ____%)
10Total Income Tax Withheld (may not equal W-2; see Instructions)
11Quarterly and Extension Payments/Credit From Previous Year
12Credits: Out-of-State, Philadelphia (enclose supporting documents)
13TOTAL PAYMENTS and CREDITS (add Lines 10, 11, and 12)
14Refund: enter if more than $1; or select credit option in Line 15
15Credit to Taxpayer/Spouse if more than $1, apply credit as follows
Credit to next year Credit to spouse
EARNED INCOME TAX BALANCE DUE (Line 9 minus Line 1316
17 Penalty after April 15 (see instructions)
18 Interest after April 15 (see instructions)
19 TOTAL PAYMENT DUE (add Lines 16, 17 and 18) Payable to “LCTCB”