Online Customer Care

*Address *City *State *Zip Code *E-mail Address *Social Security Number(Last 4 Digits) Township, Boro, City School District *Telephone Number How long have you lived at the above address? From To If you have lived at the above address less than 2 years, Previous Street Address Previous City Previous State Previous Zip Code Individual File Maintenance Form Employment Jurisdiction Resident Jurisdiction Township, Boro, City School District Does your employer withhold the Local Earned Income Tax from your pay? Do you own your own business? If you have no income at this time, please specify. Other (Please specify) County County *Name (###-###-####) Please Tab from field to field, do not Enter.

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