OCCUPATION PRIVILEGE TAX FOR THE YEAR______(EVIDENCE OF DEDUCTION CERTIFICATE)
 Calendar year Jan. 1 to Dec. 31
BOROUGH OF PENNSBURG BOROUGH ORDINANCE # 2-99
 MONTGOMERY COUNTY, PA
You are entitled to receive a written explanation, at no charge, of your rights with regard to the audit, appeal, enforcement,
 refund and collection of this tax by calling the tax collector at (215) 679-4546 ext. 3, during the hours of 
 9:00 a.m. to 3:00 p.m., Monday – Friday.
Mail Evidence of Deduction Certificate along with the
 Employer’s Return and mail payment to:
Borough of Pennsburg
76 West 6th Street
Pennsburg, PA 18073 
 
TAX COLLECTOR COPY
______
OCCUPATION PRIVILEGE TAX FOR THE YEAR______(EVIDENCE OF DEDUCTION CERTIFICATE)
 Calendar year Jan. 1 to Dec. 31
BOROUGH OF PENNSBURG BOROUGH ORDINANCE # 2-99
 MONTGOMERY COUNTY, PA
You are entitled to receive a written explanation, at no charge, of your rights with regard to the audit, appeal, enforcement,
 refund and collection of this tax by calling the tax collector at (215) 679-4546 ext. 3, during the hours of 
 9:00 a.m. to 3:00 p.m., Monday – Friday.
Mail Evidence of Deduction Certificate along with the
 Employer’s Return and mail payment to:
Borough of Pennsburg
76 West 6th Street
Pennsburg, PA 18073 
 
EMPLOYER’S COPY
______
OCCUPATION PRIVILEGE TAX FOR THE YEAR______(EVIDENCE OF DEDUCTION CERTIFICATE)
 Calendar year Jan. 1 to Dec. 31
BOROUGH OF PENNSBURG BOROUGH ORDINANCE # 2-99
 MONTGOMERY COUNTY, PA
You are entitled to receive a written explanation, at no charge, of your rights with regard to the audit, appeal,enforcement,
 refund and collection of this tax by calling the tax collector at (215) 679-4546 ext. 3, during the hours of 
 9:00 a.m. to 3:00 p.m., Monday – Friday.
Mail Evidence of Deduction Certificate along with the
 Employer’s Return and mail payment to:
Borough of Pennsburg
76 West 6th Street
Pennsburg, PA 18073
EMPLOYER’S NAME / DATE WITHELD / EMPLOYEE’S NAME / ADDRESS / S.S.#EMPLOYEE’S COPY
