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Certificate or Residency (EIT)

  1. Complete Sections 1 and 3 and return this form to your employer at the time of employment and when there are changes to your name and/or address.

  2. Complete Section 2 and provide this certificate to each new hire in order to obtain accurate information for the collection and distribution of Local Earned Income Taxes (EIT). This form should serve as an addendum to the employee's Form W-4.

  3. Completion of this form will allow your employer to provide the local tax collector with the information required to distribute the Local Earned Income Tax withheld from your paycheck to the correct municipality and school district. You need to provide your employer with your DOMICILE address (i.e. permanent principal physical address.) This address may differ from your mailing address. Please see the reverse side of this page for additional information regarding determining your domicile.

  4. For information regarding the appropriate municipality, Political Subdivision (PSD) code, and EIT rate, please visit the Pennsylvania Department of Community & Economic Development website: or contact the Centre Tax Agency at (814) 234-7120.

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