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.#

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 NAME / DATE WITHELD / EMPLOYEE’S NAME / ADDRESS / S.S.#

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