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Get PA DCED CLGS-32-5 2012

Me/Address, SSN, or Resident PSD (14) AMOUNT OF EIT WITHHELD THIS QUARTER $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . (16) THIS PAGE TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ (15) RESIDENT PSD CODE . $ . When reporting more than 20 employees, please follow accompanying electronic f.

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