Franklin County Area Tax Bureau - Tax Payer Filing
-INPUT SCREEN ONLY - USE THE BUTTON TO THE RIGHT OF THIS MESSAGE TO PRINT YOUR TAX RETURN --->   
FRANKLIN COUNTY AREA TAX BUREAU
306 NORTH 2nd STREET
CHAMBERSBURG PA 17201-1613
PHONE (717) 263-5141

OFFICE HOURS
8 A.M. TO 4:00 P.M. MON. THRU FRI.

Website: FCATB.org
TO CONSTITUTE PROOF OF FILING, THE TAXPAYER MUST HAVE A VALIDATED RECEIPT FROM THE TAX OFFICE. TO OBTAIN A RECEIPT BY MAIL, INCLUDE A SELF ADDRESSED STAMPED ENVELOPE WHEN FILING.
Local Earned Income and
Net Profits Tax Return
(Form 531)
TYPE OR PRINT INFORMATION BELOW. IF PREPRINTED, CHECK FOR ACCURACY AND MAKE CORRECTIONS WHERE NECESSARY. SPOUSE'S NAME, SIGNATURE, AND OTHER INFORMATION SHOULD BE PROVIDED ONLY IF HE OR SHE IS ALSO FILING ON THIS FORM. ALL NUMERIC VALUES NEED TO ROUNDED TO NEAREST WHOLE AMOUNT! IF YOU MOVED AND/OR ENTERED AN AMOUNT ON LINE 4 OF THE ENTRY SCREEN, YOU WILL BE PROMPTED TO COMPLETE MOVING AND/OR MISCELLANEOUS INCOME SECTIONS ON A SECOND SCREEN!
Your Resident Municipality (Township or Borough):    
Name(s) and Current Address
  A - Taxpayer:
 
  B - Spouse:
 
  Street Address:
 
  City:  State:  Zip:
A HUSBAND AND WIFE MAY BOTH FILE ON THIS FORM. HOWEVER, TAX CALCULATIONS MUST BE REPORTED IN SEPARATE COLUMNS. JOINT FILING (COMBINING INCOME, ETC.) IS NOT PERMITTED.
Are you filing with a spouse
  yes   no
Did you Move between Jan 1, and the Present?
Yes   No
If yes, Complete Sections A & C on the back on this form.
Social Security # A Social Security # B
1 W-2 Earnings-Compensation (From Attached W-2's) 1
2 Employee Business Expenses-EBE's (Attach PA UE And Federal 2106 if used) 2
3 Taxable W-2 Earnings-Compensation less EBE's (Subtract Line 2 from Line 1) 3
4 Other Taxable Earned Income-From Section B on Next Page (No Interest or Dividends) 4
5 Total Taxable Earned Income-Compensation (Add Lines 3 and 4) 5
6 Net Profit(s) from Business, Profession, or Farm (Attach PA Schedules C,F,RK-1) 6
7 Net Loss(es) from Business, Profession, or Farm (Attach PA Schedules C,F,RK-1) 7
8 Taxable Profits - Subtract Line 7 from Line 6 (If Less Than Zero, Enter Zero) 8
9 Subchapter S and Other Non-Taxable Passive Income:(Attach PA RK-1's,ETC.)
Enter Passive Business,Profession,or Farm Income as Reported on your PA-40 Return		 9
10 Total Taxable Earned Income and Net Profits (Add Lines 5 and 8) 10
11
Tax
Rate		                  If you moved from one tax
rate area to another during the year,
complete a Schedule X to determine rate to enter.   		Chambersburg Area S D Residents (1.7%) Enter .017
All Other School District Residents (1%) Enter .01
 11

Schedule X Completed

Schedule X Completed
12 Tax Liability: (Multiply Line 10 by Line 11) 12
13 Total Local Income Taxes Withheld Except Philadelphia Income Tax (From Attached W-2's) 13
14 Quarterly Payments and/or Last Year's Overpayment Credited to this Year 14
15 Credit for Taxes Paid to Philadelphia and/or States other than PA (Attach Local Schedule G) 15
16 Total Withholdings, Payments, and Credits (Add Lines 13,14, and 15) 16
17 Tax Balance Due If Line 12 is Greater than Line 16 (Subtract Line 16 from Line 12) 17
18 Interest & Penalty If Paid After April 15 (See Instructions) 18
Interest and Penalty Calculator
(If your tax liability on line 17 changes, you must recalculate Interest & Penalty)
19 Late Filing Fee - Enter $10.00 After April 15 ($20.00 After December 31) 19
20 Quarterly Interest & Penalty (See Instructions) 20
21 Total Due (Add Lines 17,18,19, and 20.) Make check payable to "FCATB"     
If $1.00 Or Less, Enter Zero		 21
If Line 21 was paid by credit/debit card, enter Official Payments Corp. Confirmation Number(s) here
22 Overpayment if Line 16 is Greater than Line 12 (Subtract Line 12 from Line 16)
If $1.00 Or Less, Enter Zero		 22
23 Amount of Line 22 to be Refunded 23
24 Amount of Line 22 to be credited to Next Year's Tax 24
25 Amount of Line 22 to be credited to Spouse's balance Due on Line 21 25
Direct
Deposit
Information
for Refund
Taxpayer 'A','B', or 'Both' 'Savings or 'Checking'
Account		 Routing Number Account Number
I DECLARE UNDER PENALTIES PROVIDED BY LAW, THAT THIS RETURN IS TRUE COMPLETE AND CORRECT
You Must Sign and Date the Printed Version of this Return Occupation:
Daytime Phone:
Your Spouse Must Sign and Date the Printed Version of this Return Occupation:
Daytime Phone:
Paid Preparer's Name (Please Print):
 Paid Preparer's EIN:
Paid Preparer's Phone: