Form Bp A0642 PDF Details

At the heart of many decisions to move for work, especially within the U.S. Department of Justice, lies the Relocation Income Tax Allowance (RITA) Certification, encapsulated in the form BP-A0642. This form, designed by the Federal Bureau of Prisons, plays a crucial role in ensuring employees who relocate for work are duly compensated for potential income tax implications of their move. It requests detailed information from the employee, such as personal identification, work and home addresses, Social Security number, and the date of transfer. More than just a formality, the BP-A0642 requires the filer to provide comprehensive financial data, including gross compensation from W-2 forms, net earnings from self-employment (Schedule SE), and details regarding locality taxes, if applicable. This allows for the calculation of the RITA accurately and fairly, based on the employee's or, if filing jointly, the employee and the spouse's income tax returns for the relevant tax year. The form also accommodates special circumstances, such as having relocated more than once within the tax year, and underscores the filer's commitment to correctness and transparency by requiring signatures as a certification of the information's accuracy. Beyond its bureaucratic function, the BP-A0642 form embodies the government's acknowledgment of the financial strain moving can place on its workers and offers a structured pathway to mitigate it.

QuestionAnswer
Form NameForm Bp A0642
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesPDF, P2200, rita status certification form, BP-A0642

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BP-A0642

 

 

 

JUN 10

 

 

U.S. DEPARTMENT OF JUSTICE

RELOCATION INCOME TAX ALLOWANCE (RITA) CERTIFICATION

FEDERAL BUREAU OF PRISONS

 

 

 

 

 

 

 

 

Name:

 

Phone #:

Work

Address:

 

 

Home

 

 

Soc. Sec. #:

 

 

 

Transfer Date:

 

I certify that the following information, which is to be used in calculating the RITA for which I am entitled, has been (or will be shown on the income tax

returns filed (or to be filed) by me (or by my spouse and me) with the applicable Federal, State and local tax authorities for tax year.

FILING STATUS

 

 

Single

 

Head of Household

 

Married Filing

 

Married Filing

Joint Return

 

Separate Return

GROSS COMPENSATION

 

 

*from Form(s) W-2 (including Relocation) and/or net earnings on Schedule SE (only applicable for self-employment)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Line 1 + Line 2

 

 

 

 

 

 

 

 

Forms W-2

 

 

 

 

 

Schedule SE

Employee

 

 

 

 

$

 

 

 

 

 

 

 

$

 

 

$

 

 

 

 

 

 

 

$

 

Spouse (if filing joint return)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

TOTAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LOCALITY TAX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Do you pay a locality tax (city or county income tax)?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If so, what is the tax rate?

 

 

 

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is the tax a percentage of

 

 

 

 

income?

 

 

state tax? or

 

 

federal tax?

 

 

 

 

 

 

 

 

* If you received relocation reimbursements for two moves

 

 

 

* From your old residence, is the distance to your new duty

during this tax year, please list the cities and states to which

 

 

 

station at least 35 miles greater than the distance to your old

you relocated.

 

 

 

duty station?

 

 

 

 

 

 

 

 

1st Move 2nd Move

The above information is true and accurate to the best of my knowledge. I/we agree to notify Relocation Services of any changes to the above (i.e., from the amended tax returns, tax audit, etc.) so that appropriate adjustment to the RITA may be made. Additional documentation will be furnished upon request.

Employee's Signature

 

Date

 

 

 

 

 

Date

Spouse's Signature (if filling joint return)

 

 

*Please be sure that all W-2 forms and Schedules (if applicable) are attached.

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