Form CLGS-32-5 Employer Quarterly Return - Local Earned Income Tax Withholding - Pennsylvania

Form clgs-32-5 is a Pennsylvania Department of Revenue form also known as the "Employer Quarterly Return - Local Earned Income Tax Withholding". The latest edition of the form was released in June 1, 2013 and is available for digital filing.

Download an up-to-date fillable Form clgs-32-5 in PDF-format down below or look it up on the Pennsylvania Department of Revenue Forms website.

ADVERTISEMENT
CLGS-32-5 (06-13)
EMPLOYER QUARTERLY RETURN
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 BUSINESS NAME (Use Federal ID Name)
EMPLOYER BUSINESS LOCATION - STREET ADDRESS (No PO Box, RD or RR)
SECOND LINE OF ADDRESS
CITY
STATE
ZIP
MUNICIPAL TAXING AUTHORITY (City, Borough, Township) IN WHICH FACILITY OR BUSINESS IS LOCATED
(Attach listing of multiple locations within PA if applicable)
COUNTY
BUSINESS PHONE NUMBER
BUSINESS FAX NUMBER
EMPLOYER PSD CODE
FEDERAL EIN OR SOCIAL SECURITY #
ACCOUNT NUMBER
YEAR AND QUARTER
1. Total Earned Income Tax Withheld . . . . . . . . . . . . $
8. Date Period Ended
. . . . . . . . . . . .
(MM/DD/YYYY)
2. Credit or Adjustment
. . . . . . . . . $
9. Total Pages of This Return . . . . . . . . . . . . . . . . . .
(attach explanation)
3. Total of Earned Income Tax Due
$
10. Total Number of Employees Listed . . . . . . . . . . .
(line 1 minus line 2) .
4. Total Payments Made this Quarter . . . . . . . . . . . . . $
If there has been a change of ownership or other transfer of business during
the quarter, attach explanation and give name of present owner and date the
5. Adjusted Total of EIT Due
. . . . . . $
(line 3 minus line 4)
change took place.
CHANGE 
NO CHANGE
6. Penalty & Interest
$
___%
Do you expect to pay taxable wages next quarter? 
Yes
No
7. Balance Due with Return
. . . . $
(Add lines 5 and 6)
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)
(13) GROSS 
(14) AMOUNT OF EIT
(15) RESIDENT
(11) EMPLOYEE’S SOCIAL 
(12) EMPLOYEE’S NAME/ADDRESS
COMPENSATION PAID
WITHHELD THIS
SECURITY NUMBER
PSD CODE
THIS QUARTER
QUARTER
$
$
$
$
$
$
$
$
(16) FIRST PAGE TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
$
Make Checks payable to: __________________________
$
TOTAL Amount Enclosed . . . . . . .
There will be a $_______ fee for returned payments & checks.
NOT to be filed with the PA Department of Revenue. Please file with your local EIT Collector.
CLGS-32-5 (06-13)
EMPLOYER QUARTERLY RETURN
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 BUSINESS NAME (Use Federal ID Name)
EMPLOYER BUSINESS LOCATION - STREET ADDRESS (No PO Box, RD or RR)
SECOND LINE OF ADDRESS
CITY
STATE
ZIP
MUNICIPAL TAXING AUTHORITY (City, Borough, Township) IN WHICH FACILITY OR BUSINESS IS LOCATED
(Attach listing of multiple locations within PA if applicable)
COUNTY
BUSINESS PHONE NUMBER
BUSINESS FAX NUMBER
EMPLOYER PSD CODE
FEDERAL EIN OR SOCIAL SECURITY #
ACCOUNT NUMBER
YEAR AND QUARTER
1. Total Earned Income Tax Withheld . . . . . . . . . . . . $
8. Date Period Ended
. . . . . . . . . . . .
(MM/DD/YYYY)
2. Credit or Adjustment
. . . . . . . . . $
9. Total Pages of This Return . . . . . . . . . . . . . . . . . .
(attach explanation)
3. Total of Earned Income Tax Due
$
10. Total Number of Employees Listed . . . . . . . . . . .
(line 1 minus line 2) .
4. Total Payments Made this Quarter . . . . . . . . . . . . . $
If there has been a change of ownership or other transfer of business during
the quarter, attach explanation and give name of present owner and date the
5. Adjusted Total of EIT Due
. . . . . . $
(line 3 minus line 4)
change took place.
CHANGE 
NO CHANGE
6. Penalty & Interest
$
___%
Do you expect to pay taxable wages next quarter? 
Yes
No
7. Balance Due with Return
. . . . $
(Add lines 5 and 6)
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)
(13) GROSS 
(14) AMOUNT OF EIT
(15) RESIDENT
(11) EMPLOYEE’S SOCIAL 
(12) EMPLOYEE’S NAME/ADDRESS
COMPENSATION PAID
WITHHELD THIS
SECURITY NUMBER
PSD CODE
THIS QUARTER
QUARTER
$
$
$
$
$
$
$
$
(16) FIRST PAGE TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
$
Make Checks payable to: __________________________
$
TOTAL Amount Enclosed . . . . . . .
There will be a $_______ fee for returned payments & checks.
NOT to be filed with the PA Department of Revenue. Please file with your local EIT Collector.
EMPLOYER QUARTERLY RETURN for Local Earned Income Tax Withholding
CLGS-32-5 (06-13)
Employer Business Location: ___________________________________________________________________________ Year and Quarter: ______________
(13) GROSS 
(14) AMOUNT OF EIT
(15) RESIDENT
(11) EMPLOYEE’S SOCIAL 
(12) EMPLOYEE’S NAME/ADDRESS
COMPENSATION PAID
WITHHELD THIS
SECURITY NUMBER
PSD CODE
THIS QUARTER
QUARTER
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
(16) THIS PAGE TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
$

Download Form CLGS-32-5 Employer Quarterly Return - Local Earned Income Tax Withholding - Pennsylvania

1147 times
Rate
4.4(4.4 / 5) 69 votes
ADVERTISEMENT
Page of 2