Philadelphia Wage Tax Refund Petition Form PDF Details

Are you a Philadelphia resident or employer struggling with the city's wage tax? The City of Philadelphia recently added a petition form to their website in an effort to provide relief for taxpayers who are currently dealing with their outdated and rigid salary taxation system. This new petition form provides an easier way for individuals and businesses to get the refund they deserve from any overpayment of the city's wages. In this blog post, we'll take you through everything that you need to know about filling out the Wage Tax Refund Petition Form, including how it works and what documents are needed when applying. We hope this guide will help alleviate some of your difficulties associated with negotiating Philadelphia's labor laws so that you can receive your tax refund quickly without any extra hassles.

QuestionAnswer
Form NamePhiladelphia Wage Tax Refund Petition Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other nameswage tax refund petition 2020, 2020 wage tax refund petition philadelphia, fillable philadelphia wage tax refund petition, philadelphia wage tax refund petition 2020

Form Preview Example

 

 

 

PETITION NUMBER (Office use only)

CITY OF PHILADELPHIA

DEPARTMENT OF REVENUE

 

 

 

REFUND PETITION

 

 

 

FUND

SOURCE

INDEX

For all refunds except Individual Employee Wage Tax

SEE INSTRUCTIONS ON REVERSE. CLEARLY PRINT OR TYPE ALL INFORMATION.

1. PETITIONER'S NAME (First Name, Middle Initial, Last Name)

2.BUSINESS NAME

3.MAILING ADDRESS

CITY

4.SOCIAL SECURITY NUMBER

5.FEDERAL EMPLOYER IDENTIFICATION NO.

STATE

ZIP CODE

 

 

6. PROPERTY ADDRESS (For Real Estate, Water, Commercial Waste and Business Use & Occupancy Refunds only)

7. PHONE NUMBER

FAX NUMBER

E-MAIL ADDRESS

8.REFUND TYPE (Check all that apply and list below. For Wage Tax, Real Estate Tax and Other, see important information on reverse.)

 

 

Wage Tax

 

 

Business Income & Receipts Tax *

 

 

Net Profits Tax

 

 

Business Use & Occupancy Tax

 

 

Parking Tax

 

 

Amusement Tax

 

 

 

Water/Sewer

 

 

Liquor Tax

 

 

 

 

 

 

 

 

 

 

 

 

 

Hotel Tax

 

 

Commercial Waste

 

 

School Income Tax

 

 

Licenses and Permits

 

 

 

 

 

 

 

 

 

 

Tobacco Tax

 

 

Earnings Tax

 

 

 

Police Services

 

 

Departmental Payments

 

 

 

 

 

 

 

 

 

 

 

Real Estate Tax

 

 

Other (specify)______________________________________

* Business Income & Receipts Tax prior to 2012

 

 

 

 

 

was known as Business Privilege Tax.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A. TAX ACCOUNT

 

B. TAX YEAR OR

 

C. AMOUNT OF

 

A. TAX ACCOUNT

B. TAX YEAR OR

C. AMOUNT OF

 

NUMBER

 

PERIOD/YEAR

 

CLAIM

 

 

NUMBER

PERIOD/YEAR

CLAIM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9. REASON FOR THIS REFUND PETITION

I HEREBY CERTIFY that the statements contained herein and in any supporting schedule or exhibit are true and correct to the best of my knowledge and belief. I understand that if I knowingly make any false statements herein, I am subject to penalties as prescribed by law.

PETITIONER'S SIGNATURE

 

DATE

 

 

 

AUTHORIZED SIGNATURE FOR OTHER DEPARTMENT

TITLE

DATE

 

 

 

MAIL COMPLETED REFUND PETITION TO:

REFUND INFORMATION:

 

OR FAX TO: 215-686-6228

 

TELEPHONE: 215-686-6574, 6575, 6578

CITY OF PHILADELPHIA

FAX: 215-686-6228

 

DEPARTMENT OF REVENUE

 

E-MAIL: refund.unit@phila.gov

 

P.O. BOX 1137

 

INTERNET: www.phila.gov/revenue

PHILADELPHIA, PA 19102-1137

 

 

83-A-15 (Rev 4-29-2013)

Instructions for Completing the Refund Petition

This form is to be used for all refund requests except Individual Employee Wage Tax. If you need to file an individual employee wage petition, refer to the contact information on the front of this form. Employers must use this petition for withheld wage tax refund requests.

1.Individuals - Enter the name of the petitioner.

2.Business Name - For non-individual petitioners, enter the name of the entity.

3.Mailing Address - Enter the address where the refund is to be mailed.

4 and 5. Social Security and Federal Employer Identification Numbers - Individuals must enter a Social

Security number. All other entities must enter a Federal Employer Identification Number.

6.Property Address - This is required for all Real Estate, Water/Sewer, Commercial Waste and Business Use & Occupancy petitions. Enter the address of the property for which the refund is being requested.

7.Contact Information - Provide a phone number, fax number and e-mail address where you can be reached.

8.Refund Type - Check the appropriate block(s). If the type is not listed on the front of this form, check "Other" and specify the type of refund requested. A single Refund Petition may be used for multiple tax types and years.

A.Tax Account Number - Enter the tax specific account number(s).

B.Tax Years and/or Tax Periods - If tax is an annual tax, enter year. If tax is periodic,

e.g., quarterly or monthly, enter period(s) and year(s).

C.Amount of Claim - Enter the amount of the refund requested.

9.Reason for Refund - Enter reason for refund. If you have additional documentation, attach to this petition.

Wage Tax - Additional information is required before a decision can be made on your refund request. Provide a letter on company letterhead (signed by an officer of the company) stating that the additional tax withheld has been returned to the employees. If your refund request is resulting from a duplicate payment, provide supporting documentation. If you have questions about your filing requirements, application of payments or tax balances, call Taxpayer Services at 215-686-6600.

Real Estate - Refund requests must be accompanied by a copy of the front and back of the canceled check(s). If the refund is due to a sale of the property or refinancing, you must also supply a copy of the settlement sheet. Mortgage companies must supply a copy of the disbursement/check listing.

This petition must be signed and dated! If you have any questions regarding the preparation of this petition, see the contact information on the front of this form.

OFFICE USE ONLY - Licenses and Permits; Interdepartmental Refunds and Other - All petitions must include the signature and title of the Department's authorized designee, along with the Fund, Source and Index Code of the payment in addition to the petitioner's signature.

83-A-15 Reverse (Rev. 4-29-2013)