Transaction No. 37 Complete Pennsylvania Form Rev-1667, W-2 Transmittal. Use the information on Forms W-2 to complete the report. The wages paid and the Pennsylvania tax withheld for the first three quarters are: Quarter Wages Tax Withheld 1st $34,088.75 $1,046.52 2nd $45,535.62 $1,397.94 $1,921.83 3rd $62,600.20 Hint: 4th quarter's earnings total does not include payments to an estate. If an amount is zero, enter "O". Click here to access the Wage-Bracket Method Tables. R pennsylvania YEAR EMPLOYER ACCOUNT ID ENTITY IC START REV-1667 (AS) 12-17 DEPARTMENT OF REVENUE 2 0 0 0 0 0 3 3 0 0 0 0 Part I RECONCILIATION 1a Number of W-2 forms attached DUE DA 1b Number of 1099 forms with PA withholding JANUARY Totale mancntianddictrihufian Part I RECONCILIATION 1a Number of W-2 forms attached DUE DATE 1b Number of 1099 forms with PA withholding JANUARY 31 2. Total compensation/distribution subject to PA withholding ANNUAL WITHHOLDING RECONCILIATION STATEMEI 3 PA personal income tax withheld BUSINESS NAME AND ADDRE Part II ANNUAL RECONCILIATION LEGAL NAME Wages/distribution paid subject to PA withholding PA tax withheld 1st Quarter GLO-BRITE PAINT COMPANY TRADE NAME 2nd Quarter ADDRESS 3rd Quarter 4th Quarter 2215 SALVADOR STREET CITY, STATE, ZIP TOTAL PHILADELPHIA, PA 19175-0682 DO NOT SEND PAYMENT WITH THI RESET FORM PRINT MM/DD/YYYY DATE DAYTIME TELEPHONE # TITIE CITun Transaction No. 37 Complete Pennsylvania Form Rev-1667, W-2 Transmittal. Use the information on Forms W-2 to complete the report. The wages paid and the Pennsylvania tax withheld for the first three quarters are: Quarter Wages Tax Withheld 1st $34,088.75 $1,046.52 2nd $45,535.62 $1,397.94 $1,921.83 3rd $62,600.20 Hint: 4th quarter's earnings total does not include payments to an estate. If an amount is zero, enter "O". Click here to access the Wage-Bracket Method Tables. R pennsylvania YEAR EMPLOYER ACCOUNT ID ENTITY IC START REV-1667 (AS) 12-17 DEPARTMENT OF REVENUE 2 0 0 0 0 0 3 3 0 0 0 0 Part I RECONCILIATION 1a Number of W-2 forms attached DUE DA 1b Number of 1099 forms with PA withholding JANUARY Totale mancntianddictrihufian Part I RECONCILIATION 1a Number of W-2 forms attached DUE DATE 1b Number of 1099 forms with PA withholding JANUARY 31 2. Total compensation/distribution subject to PA withholding ANNUAL WITHHOLDING RECONCILIATION STATEMEI 3 PA personal income tax withheld BUSINESS NAME AND ADDRE Part II ANNUAL RECONCILIATION LEGAL NAME Wages/distribution paid subject to PA withholding PA tax withheld 1st Quarter GLO-BRITE PAINT COMPANY TRADE NAME 2nd Quarter ADDRESS 3rd Quarter 4th Quarter 2215 SALVADOR STREET CITY, STATE, ZIP TOTAL PHILADELPHIA, PA 19175-0682 DO NOT SEND PAYMENT WITH THI RESET FORM PRINT MM/DD/YYYY DATE DAYTIME TELEPHONE # TITIE CITun