Establishing secure connection…Loading editor…Preparing document…

Taxpayer Annual Local Earned Income Tax Return

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

TAXPAYER ANNUAL LOCAL EARNED INCOME TAX RETURN

INSTRUCTIONS

A. General Instructions

1. When To File: All Pennsylvania residents with earned income, wages or net profits must file a local earned income tax return online or by mail by April 18, 2017. Even if you have employer withholding or are not expecting a refund, you must still file a timely return.

2. Where To File: File with the local earned income tax collector serving your resident Tax Collection District. Only complete part-year resident address fields if you moved during the year.

3. Effective Dates: January 1 through December 31, unless otherwise noted.

4. Resident PSD Code: Provide a Resident PSD (political subdivision) Code for where you lived during the tax year.

5. Extension: If requesting an extension, submit an Extension Request Form on or before April 18 and pay tax due.

6. Amended Return: When amending a PA Income Tax Return (PA-40), amend and re-file this local earned income tax return.

7. Receipt/Copy: An online confirmation or canceled check is sufficient proof of payment.

8. Penalty and Interest: If tax is not paid when due, penalty and interest will accrue.

9. Round Cents: Round to the nearest whole dollar.

10. Ink: Use Black or Blue Ink Only.

B. Regulations/Line-by-Line Instructions

LINE 1: Gross compensation as reported on W-2.

LINE 2: Allowable employee business expenses. Enclose PA Schedule UE.

LINE 3: Other taxable earned income.

LINE 4: Total taxable earned income.

LINES 5 and 6: Net profit/net loss from business.

LINE 7: Total taxable net profit.

LINE 8: Total taxable earned income and net profit.

LINE 9: Tax liability.

LINE 10: Earned income tax withheld.

LINE 11: Quarterly and extension payments / credit from previous tax year.

LINE 12: Out-of-state and Philadelphia credits.

LINE 13: Total payments and credits.

LINE 14: Refund.

LINE 15: Credit.

LINE 16: Earned income tax balance due.

LINES 17 and 18: Penalty and interest.

LINE 19: Total payment due.


RETURN INFORMATION

Tax Year:

Effective Date:

Resident PSD Code:

Taxpayer Name:

Spouse Name:

Current Address:

City:

State:

ZIP:

Part-Year Resident Address:

Phone Number:

Email Address:

INCOME / TAX CALCULATION

Line 1 - Gross compensation as reported on W-2:

Line 2 - Allowable employee business expenses:

Line 3 - Other taxable earned income:

Line 4 - Total taxable earned income:

Line 5 - Net profit from business:

Line 6 - Net loss from business:

Line 7 - Total taxable net profit:

Line 8 - Total taxable earned income and net profit:

Line 9 - Tax liability:

Line 10 - Earned income tax withheld:

Line 11 - Quarterly and extension payments / credit from previous tax year:

Line 12 - Out-of-state and Philadelphia credits:

Line 13 - Total payments and credits:

Line 14 - Refund:

Line 15 - Credit:

Line 16 - Earned income tax balance due:

Line 17 - Penalty:

Line 18 - Interest:

Line 19 - Total payment due:

SUPPORTING INFORMATION

Have you enclosed W-2s and supporting schedules?

Have you enclosed PA Schedule UE?

Have you enclosed Schedule G-L or out-of-state return?

Additional Notes:

SIGNATURES

Taxpayer Signature:

Date:

Spouse Signature:

Date:

Preparer Name:

Preparer Phone:

Refund or Credit Due

Keystone Collections Group
PO Box 509
Irwin, PA 15642-0509

Payment Enclosed

Keystone Collections Group
PO Box 529
Irwin, PA 15642-0529

No Payment/No Refund

Keystone Collections Group
PO Box 549
Irwin, PA 15642-0549

Go Paperless — Use a PC, Mac, Tablet or Any Smart Device

Enter text✕

Overview of the Taxpayer Annual Local Earned Income Tax Return

The Taxpayer Annual Local Earned Income Tax Return documents an individual’s gross earned income subject to municipal or local earned income taxes and reports tax withheld or due for the calendar year. It is typically filed by residents or nonresidents who worked in a taxing municipality, and by employers or agents who remit withholdings on behalf of employees. The return reconciles wages, credits, and withholding, supports local budget allocations, and provides the tax authority with the information needed to assess and collect locally imposed earned income tax.

Why this annual local earned income return matters

Filing an accurate annual local earned income tax return ensures compliance with municipal tax ordinances, prevents penalties, and documents withholding credits that reduce taxpayer liability. It also finalizes the yearly reconciliation between wages reported and taxes remitted to local authorities.

Why this annual local earned income return matters

Who typically completes this local earned income return

The return is completed by individual taxpayers, payroll administrators, and tax preparers responsible for local withholding reconciliation.

  • Individual taxpayers who live or work in jurisdictions that levy a local earned income tax; they report wages and claim credits.
  • Employers or payroll providers reconciling annual withholding for employees subject to multiple local taxing authorities.
  • Certified tax preparers and municipal tax officers preparing or reviewing consolidated local filings for accuracy and audit readiness.

Accurate completion protects against late-filing penalties and supports correct tax credit application at the municipal level.

Core parts of a professionally prepared local earned income return

A professional annual local earned income return groups identification, income, withholding, credits, calculations, and certification into a single, verifiable document for municipal tax authorities.

Taxpayer ID

Full legal name and SSN/TIN exactly as on IRS records to match federal reporting and avoid backup withholding.

Employer Data

Employer name, local office location, and employer identification number used to allocate withholding to correct municipality.

Income Detail

Gross wages, taxable compensation, and other earned income broken down by employer and municipality when required.

Withholding

Total local tax withheld during the year by employer(s), with separate lines for each taxing jurisdiction if applicable.

Credits & Adjustments

Credits for prior payments, reciprocity agreements, and withholding adjustments to prevent double taxation.

Signature & Date

Taxpayer signature, date, and preparer information certifying accuracy under penalty of law.

Required data elements to include on the return

Taxpayer name: Full legal name
SSN or TIN: Nine-digit number
Mailing address: Street, city, state, ZIP
Employer name: Legal employer name
Total wages: Annual gross wages
Local tax withheld: Withholding amount

Step-by-step: completing and filing the annual local return

Follow these sequential steps to assemble, verify, and submit the annual local earned income tax return to the correct municipal authority.

  • 01
    Gather documents: Collect W-2s, pay stubs, and prior local tax statements.
  • 02
    Reconcile amounts: Verify wages and withholding match employer reports.
  • 03
    Complete form: Enter identification, income, credits, and calculations.
  • 04
    Submit and retain: File with local authority and keep signed copy.

Configuring an online workflow for electronic completion

Set up a consistent digital workflow to collect data, authenticate signers, and route returns to local tax authorities or payroll teams.

Field Configuration
E-filing endpoint Municipal portal upload or secure email
Authentication Email link, SMS code, or multi-factor
Bulk filing Template batch processing for multiple taxpayers
Notifications Automated confirmations and status emails

Where to send or file your completed return

After signing, route the return to the appropriate municipal tax office, payroll department, or tax agent per local instructions.

  • Municipal tax office: Submit via municipality portal or mail as directed.
  • Employer payroll: Provide copy to employer for reconciliation and remittance.
  • Tax preparer: Deliver signed return to your preparer for filing.
  • Retention copy: Store a signed PDF for your records and audits.

Digital signing and technical requirements

Use a platform that supports secure PDF forms, audit trails, and the authentication level required by your municipality.

  • File formats: PDF, DOCX, or fillable PDF
  • Integrations: Connect to payroll and cloud storage
  • Authentication: Email, SMS, or advanced 2FA

Confirm the recipient accepts e-submissions under ESIGN (15 U.S.C. ch. 96) or applicable state law and retain the audit trail for recordkeeping.

Key filing dates and annual deadlines

Local filing deadlines often align with federal dates but can vary by municipality; confirm deadlines with the taxing authority before submitting.

Annual tax return due:

Typically April 15; check local ordinance

W-2/1099 reporting:

Jan 31 to recipients for wage statements

Paper IRS filings:

Feb 28 for many information returns

Electronic IRS filings:

Mar 31 for electronic 1099-MISC transfers

Extensions:

Federal Form 4868 extends filing to Oct 15

Milestones in the annual filing cycle

Track these sequential milestones from preparation through final acceptance to prevent late submissions and penalties.

01

Prepare records

Compile W-2s, 1099s, and payroll summaries for review.

02

Verify withholding

Reconcile employer-reported withholding with your records and claim applicable credits.

03

File return

Submit to municipality before the local deadline using approved method.

04

Confirm acceptance

Retain proof of filing and any municipal receipts or acknowledgement.

Common mistakes to avoid when preparing the return

  • Using an incorrect SSN/TIN that does not match IRS records, which can trigger backup withholding and processing delays.
  • Failing to allocate wages to the correct municipality when working for multiple employers or in multiple taxing jurisdictions.
  • Omitting employer identification or failing to include withholding entries, causing mismatches with municipal records.
  • Submitting unsigned or improperly dated returns, or using an unauthorized e-signature method where the municipality requires notarization.

Penalties and risks for incorrect or late returns

Information return fines: IRC §6721: $60–$660+ per form
Late-filing penalties: Municipal fines and interest may apply
Backup withholding: 24% withholding for missing/incorrect TIN
Intentional disregard: Higher penalties with no maximum
I-9 related risk: Form I-9 violations $281–$2,789 each
Audit exposure: Inaccuracies increase audit likelihood

Practical tips for accurate and efficient filing

Adopt consistent procedures and controls to minimize errors and streamline annual reconciliation.

Verify identity and TIN accuracy
Confirm names and SSN/TINs against Social Security or IRS-issued documents before submission; mismatches cause processing delays and potential backup withholding.
Collect employer documentation early
Request W-2s and local withholding statements promptly from employers to allow time for reconciliation and correction before deadlines.
Use templates and validation
Employ standardized templates with calculated fields and validation checks to reduce manual entry errors and ensure consistent totals across lines.
Retain audit trails and proofs
Keep signed PDFs, submission acknowledgements, and audit logs for the retention period required by governing authorities and for potential audits.

eSignature vendor comparison for annual local tax workflows

Compare common eSignature vendor criteria relevant to filing and signing tax returns. signNow is listed first per available plan data and capability indicators.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Varies by plan Varies by plan Varies by plan Varies by plan
Bulk Send Yes (Business Premium) Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes (BAA) Yes Yes No No
Envelope Cap No cap 100 envelopes/user/year Varies by plan Varies by plan Varies by plan

Real-world examples of digital signing in tax workflows

Organizations of various sizes use e-signatures to collect annual tax returns and speed reconciliation with municipal tax authorities.

Martin Properties

Martin Properties used e-signatures to process tenant and contractor tax forms faster.

  • Reduced in-person handling and mailing costs.
  • "I can process and execute all of these documents online with 100% compliance and built-in security. Whether on mobile or working offline, I can get forms back to their necessary parties efficiently."

Fertility Centers of Illinois

A healthcare provider consolidated provider and payroll forms using digital workflows.

  • Improved signer convenience and audit traceability.
  • "The airSlate SignNow team has been exceptional, responsive, the API has been great, and we're extremely happy that we chose airSlate SignNow as a company."

Frequently asked questions about the local earned income tax return

Answers to common questions about e-filing, signatures, corrections, and penalties for the annual local earned income tax return.


Need help? Contact support

be ready to get more
Join over 28 million airSlate SignNow users