Upper Darby Township Business Privilege Tax Return Upper Darby Township, Buslness Tax Office Make Checks Payable to: Upper Darby Township Your Cancelled Check will be your reçelpt 100 Garrett Rd., Rm. 102 Upper Darby, Pa. 19082 (610)734-7604 Account No: Check if Final Return: E BUSINESS PRIVILEGE TAX- Due April 15, 2.TAX DUE: (Amount in Line 1x0.0015) 4. Additonal Tax or Credit Due (Line #: 2 minus Line #3 3) 1.Total Gross Receipts subject to Tax (includes Other Income) $ $ $L $ $ $ $ 3. Less Prior Year Estimated Tax Paid (Line 6ofL Last Year's Return) Subtract amt. 5. Current Year: Estimated (Must be at least equal to 7. Total Tax Due (Line 6 + Line 4) Gross Receipts Gross Receipts in Line 1) 6. Estimated Tax Due (Line 5x0.0015) PENALTY AND LATE CHARGES (if not filed and or paid by April 15) 8.Add 10% to Line 7 (applied to late or incomplete returns or payments) 9. Add. .5%1 to Line 71 fore each month or part thereof that return is late 10, TOTAL DUE WITH RETURN (line 7 + line 8 + line 9) ifl less than $0.00, Check Box $ for Refund (if not checked, credit will be applied to next year) Attach copies of Federal Tax Returns and Schedules or worksheets to support Gross Receipts reporteda andany. claimed exclusions or exemptions. Tax return not considered complete unless such documents are attaçhed, Name'of Business: Physical Address of Business: Type of Business: Number of Employees based in Upper Darby Township: Check if you need LST Forms D3 Seasonal,Tempory, Itinerant New Established E "Due date for tempory, seaonal or Itinerant taxpayer is70 days after completion of business IDECLARE UNDER PENALTY OF LAW THAT ALL STATEMENTS MADE HEREIN AND/OR IN SUPPORTING SCHEDULES ARE TRUE, CORRECT, AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. Preparer's Signature: Print Name: Date; Telephone No: Emait: Taxpayer's! Signature: Print Name: Date: Title: Telephone No: Email: