Form CLGS-32-4 "Employer Registration Local Earned Income Tax Withholding" - Pennsylvania

What Is Form CLGS-32-4?

This is a legal form that was released by the Pennsylvania Department of Community and Economic Development - a government authority operating within Pennsylvania. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2012;
  • The latest edition provided by the Pennsylvania Department of Community and Economic Development;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CLGS-32-4 by clicking the link below or browse more documents and templates provided by the Pennsylvania Department of Community and Economic Development.

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Download Form CLGS-32-4 "Employer Registration Local Earned Income Tax Withholding" - Pennsylvania

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CLGS-32-4 (8-12)
EMPLOYER REGISTRATION
Local Earned Income Tax Withholding
You are entitled to receive a written explanation of your rights with regard to the audit, appeal, enforcement, refund and collection of local taxes. Contact your Tax Officer.
EMPLOYER INFORMATION
EMPLOYER BUSINESS NAME (Use Federal ID Name)
MAIN CORPORATE/BUSINESS LOCATION - STREET ADDRESS (No PO Box, RD or RR)
SECOND LINE OF ADDRESS
CITY
STATE
ZIP
EMPLOYER BUSINESS LOCATION - STREET ADDRESS WITHIN PA (if same as above, leave blank. No PO Box, RD or RR)
SECOND LINE OF ADDRESS
CITY OR POST OFFICE
STATE
ZIP
MUNICIPAL TAXING AUTHORITY (City, Borough or Township) IN WHICH FACILITY OR BUSINESS IS LOCATED
COUNTY
BUSINESS PHONE NUMBER
BUSINESS FAX NUMBER
EMPLOYER PA BUSINESS LOCATION PSD CODE
FEDERAL EIN OR SOCIAL SECURITY #
ORGANIZATION
TYPE OF ORGANIZATION
LLC
Individual Proprietorship
Partnership
Association
Fiduciary
Corporation
PRIMARY NATURE/OPERATION OF BUSINESS
DATE OF INCORPORATION (MM/DD/YYYY)
DATE OPERATION BEGAN AT THIS LOCATION (MM/DD/YYYY)
ACCOUNTING INFORMATION
Does your organization have multiple site locations within Pennsylvania? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
Has your organization opted to remit EIT for employees at all locations to a single Tax Collection District? . . . . . . . . . . .
Yes
No
If YES, please insert 2-digit code for Tax Collection District Selected (choose from list on reverse side) . . . . . . . . . . . . . .
Under penalties of perjury, I (we) declare that I (we) have examined this information, including all accompanying
schedules and statements and to the best of my (our) belief, they are true, correct and complete.
PRIMARY CONTACT INDIVIDUAL (First Name, Last Name)
TITLE
PRIMARY CONTACT PHONE NUMBER
PRIMARY CONTACT EMAIL ADDRESS
SIGNATURE OF PRIMARY CONTACT INDIVIDUAL
DATE (MM/DD/YYYY)
CLGS-32-4 (8-12)
EMPLOYER REGISTRATION
Local Earned Income Tax Withholding
You are entitled to receive a written explanation of your rights with regard to the audit, appeal, enforcement, refund and collection of local taxes. Contact your Tax Officer.
EMPLOYER INFORMATION
EMPLOYER BUSINESS NAME (Use Federal ID Name)
MAIN CORPORATE/BUSINESS LOCATION - STREET ADDRESS (No PO Box, RD or RR)
SECOND LINE OF ADDRESS
CITY
STATE
ZIP
EMPLOYER BUSINESS LOCATION - STREET ADDRESS WITHIN PA (if same as above, leave blank. No PO Box, RD or RR)
SECOND LINE OF ADDRESS
CITY OR POST OFFICE
STATE
ZIP
MUNICIPAL TAXING AUTHORITY (City, Borough or Township) IN WHICH FACILITY OR BUSINESS IS LOCATED
COUNTY
BUSINESS PHONE NUMBER
BUSINESS FAX NUMBER
EMPLOYER PA BUSINESS LOCATION PSD CODE
FEDERAL EIN OR SOCIAL SECURITY #
ORGANIZATION
TYPE OF ORGANIZATION
LLC
Individual Proprietorship
Partnership
Association
Fiduciary
Corporation
PRIMARY NATURE/OPERATION OF BUSINESS
DATE OF INCORPORATION (MM/DD/YYYY)
DATE OPERATION BEGAN AT THIS LOCATION (MM/DD/YYYY)
ACCOUNTING INFORMATION
Does your organization have multiple site locations within Pennsylvania? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
Has your organization opted to remit EIT for employees at all locations to a single Tax Collection District? . . . . . . . . . . .
Yes
No
If YES, please insert 2-digit code for Tax Collection District Selected (choose from list on reverse side) . . . . . . . . . . . . . .
Under penalties of perjury, I (we) declare that I (we) have examined this information, including all accompanying
schedules and statements and to the best of my (our) belief, they are true, correct and complete.
PRIMARY CONTACT INDIVIDUAL (First Name, Last Name)
TITLE
PRIMARY CONTACT PHONE NUMBER
PRIMARY CONTACT EMAIL ADDRESS
SIGNATURE OF PRIMARY CONTACT INDIVIDUAL
DATE (MM/DD/YYYY)
Tax Collection Districts
CLGS-32-4 (8-12)
Tax Collection District
Tax Collection District
TCD Code
TCD Code
01
ADAMS TAX COLLECTION DISTRICT
32
INDIANA TAX COLLECTION DISTRICT
70
ALLEGHENY CENTRAL TAX COLLECTION DISTRICT
33
JEFFERSON TAX COLLECTION DISTRICT
71
ALLEGHENY NORTH TAX COLLECTION DISTRICT
34
JUNIATA TAX COLLECTION DISTRICT
72
ALLEGHENY SOUTHEAST TAX COLLECTION DISTRICT
35
LACKAWANNA TAX COLLECTION DISTRICT
73
ALLEGHENY SOUTHWEST TAX COLLECTION DISTRICT
36
LANCASTER TAX COLLECTION DISTRICT
03
ARMSTRONG TAX COLLECTION DISTRICT
37
LAWRENCE TAX COLLECTION DISTRICT
04
BEAVER TAX COLLECTION DISTRICT
38
LEBANON TAX COLLECTION DISTRICT
05
BEDFORD TAX COLLECTION DISTRICT
39
LEHIGH TAX COLLECTION DISTRICT
06
BERKS TAX COLLECTION DISTRICT
40
LUZERNE TAX COLLECTION DISTRICT
07
BLAIR TAX COLLECTION DISTRICT
41
LYCOMING TAX COLLECTION DISTRICT
08
BRADFORD TAX COLLECTION DISTRICT
42
MCKEAN TAX COLLECTION DISTRICT
09
BUCKS TAX COLLECTION DISTRICT
43
MERCER TAX COLLECTION DISTRICT
10
BUTLER TAX COLLECTION DISTRICT
44
MIFFLIN TAX COLLECTION DISTRICT
11
CAMBRIA TAX COLLECTION DISTRICT
45
MONROE TAX COLLECTION DISTRICT
12
CAMERON TAX COLLECTION DISTRICT
46
MONTGOMERY TAX COLLECTION DISTRICT
13
CARBON TAX COLLECTION DISTRICT
47
MONTOUR TAX COLLECTION DISTRICT
14
CENTRE TAX COLLECTION DISTRICT
48
NORTHAMPTON TAX COLLECTION DISTRICT
15
CHESTER TAX COLLECTION DISTRICT
49
NORTHUMBERLAND TAX COLLECTION DISTRICT
16
CLARION TAX COLLECTION DISTRICT
50
PERRY TAX COLLECTION DISTRICT
17
CLEARFIELD TAX COLLECTION DISTRICT
51
PHILADELPHIA TAX COLLECTION DISTRICT
18
CLINTON TAX COLLECTIO DISTRICT
52
PIKE TAX COLLECTION DISTRICT
19
COLUMBIA TAX COLLECTION DISTRICT
53
POTTER TAX COLLECTION DISTRICT
20
CRAWFORD TAX COLLECTION DISTRICT
54
SCHUYLKILL TAX COLLECTION DISTRICT
21
CUMBERLAND TAX COLLECTION DISTRICT
55
SNYDER TAX COLLECTION DISTRICT
22
DAUPHIN TAX COLLECTION DISTRICT
56
SOMERSET TAX COLLECTION DISTRICT
23
DELAWARE TAX COLLECTION DISTRICT
57
SULLIVAN TAX COLLECTION DISTRICT
24
ELK TAX COLLECTION DISTRICT
58
SUSQUEHANNA TAX COLLECTION DISTRICT
25
ERIE TAX COLLECTION DISTRICT
59
TIOGA TAX COLLECTION DISTRICT
26
FAYETTE TAX COLLECTION DISTRICT
60
UNION TAX COLLECTION DISTRICT
27
FOREST TAX COLLECTION DISTRICT
61
VENANGO TAX COLLECTION DISTRICT
28
FRANKLIN TAX COLLECTION DISTRICT
62
WARREN TAX COLLECTION DISTRICT
29
FULTON TAX COLLECTION DISTRICT
63
WASHINGTON TAX COLLECTION DISTRICT
30
GREENE TAX COLLECTION DISTRICT
64
WAYNE TAX COLLECTION DISTRICT
31
HUNTINGDON TAX COLLECTION DISTRICT
65
WESTMORELAND TAX COLLECTION DISTRICT
66
WYOMING TAX COLLECTION DISTRICT
67
YORK TAX COLLECTION DISTRICT
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