HARRISBURG PA 17128-0501-2026

1. Click ‘Get Form’ to open the HARRISBURG PA 17128-0501 document in the editor.
2. Begin with SECTION I. Fill in your name, Social Security Number (SSN), and tax year at the top of the form. Ensure accuracy as this information is crucial for processing.
3. Continue by entering the Primary Taxpayer Name and SSN, followed by your Employer Name and Federal Employer Identification Number (FEIN). This section establishes your identity and employment details.
4. In SECTION II, provide your employer's contact information including their title and phone number. This helps verify your employment status.
5. Complete the Affidavit section by confirming that you have incurred employee business expenses. Check all applicable boxes regarding reimbursement status.
6. Sign and date the form where indicated. Remember to print it out for signing as electronic signatures are not accepted here.
7. Lastly, move to SECTION III to summarize your expenses. List each claimed expense along with its description and amount, ensuring you attach photocopied receipts for verification.

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