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Pennsylvania Free Printable Personal Income Tax Employee Business Expense Affidavit (REV-775) for 2020 Pennsylvania Personal Income Tax Employee Business Expense Affidavit

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Personal Income Tax Employee Business Expense Affidavit
Personal Income Tax Employee Business Expense Affidavit (REV-775)

(EX) 09-19 (FI) REV-775 BUREAU OF INDIVIDUAL TAXES PO BOX 280501 HARRISBURG PA 17128-0501 PERSONAL INCOME TAX EMPLOYEE BUSINESS EXPENSE AFFIDAVIT Form REV-775 is to be used in the event that you are unable to provide a copy of your employer’s reimbursement policy or your employer refuses to provide you and the Department of Revenue with either an employer letter or a completed REV-757. SECTION I GENERAL INFORMATION START 1. Name SSN Tax Year ➜ 2. Primary Taxpayer Name (Shown first on the PA-40) Primary Taxpayer SSN (Shown first on the PA-40) 3. Employer Name FEIN 4. Employer Contact SECTION II Contact Title Contact Phone Number AFFIDAVIT I hereby state that I am the person named above and have incurred employee business expenses as indicated on this form for the tax year shown above. I also state that I am required to incur the employee business expenses in order to perform the duties and responsibilities of my position and that I am (please mark all that apply): Not reimbursed in any manner for the expenses. Reimbursed only for some of my expenses via a per-diem rate that is less than the federal per-diem expense rate or at a fixed amount and the reimbursed expenses at these lower rates are not included on my PA Schedule UE nor claimed on my return. Reimbursed in full for some of my expenses by my employer and the reimbursed expenses are not included on my PA Schedule UE nor claimed on my return. Signature Date PLEASE SIGN AFTER PRINTING MM/DD/YYYY Please notarize in the space below. Reset Entire Form TOP OF PAGE NEXT PAGE PRINT REV-775 (EX) 09-19 (FI) SECTION III • • • • EXPENSE SUMMARY WORKSHEET Section - List the section of the PA Schedule UE where the expense was claimed. Line # - List the respective line from the PA Schedule UE where the expense was claimed. Claimed Expense Description - Provide a description of the item being claimed and provide the business related purpose. Claimed Expense Amount - Provide the amount of expense being claimed. Photocopied receipts are required to support the expenses claimed and all expenses must be clearly identified on the receipt(s). SECTION LINE # Reset Entire Form CLAIMED EXPENSE AMOUNT CLAIMED EXPENSE DESCRIPTION PREVIOUS PAGE NEXT PAGE PRINT Pennsylvania Department of Revenue Instructions for REV-775 Personal Income Tax Employee Business Expense Affidavit REV-775 IN (EX) 09-19 GENERAL INFORMATION Prior to completing this affidavit, please read brochure REV-637, Unreimbursed Allowable Employee Business Expenses for PA Personal Income Tax Purposes. Please remember that for an expense to be allowable, it must meet all of the following conditions: BLOCK 4 Provide the name of a contact within your employer’s human resource, payroll or accounting office; including their title and phone number. So we have a point of contact to affirm any assertions being made. SECTION II 1. The actual amount paid must be reported. Expenses may not be estimated, guessed or calculated using federal per diem rates. Complete the appropriate information on the affidavit, sign the form, and have the document notarized by a licensed Notary Public. 2. The expenses must be reasonable. The amount of expenses should not be excessive in relation to income, type of expenditure or purpose of expense. SECTION III 3. The expenses must be necessary and a condition of employment. Expenses cannot be incurred to make the job more convenient or productive. 4. Only ordinary expenses are allowable. The expenses must be similar to those incurred by other employees in the same trade or profession. 5. The expenses must be directly related to the employee’s present trade, business or profession. Expenses from a previous job or incurred for a future occupation may not be taken as Unreimbursed Expenses. 6. The expenses must be unreimbursed. SECTION I BLOCK 1 Provide the required information for the taxpayer (employee) claiming the business expenses. BLOCK 2 Provide the required information for the primary taxpayer listed on the PA-40. BLOCK 3 Provide the employer’s name and federal employer identification number. www.revenue.pa.gov Reset Entire Form PREVIOUS PAGE To expedite the processing of your income tax return, provide a detailed listing of your expenses and photocopies of any original expense documentation with the submission of your affidavit. (See Expense Summary Worksheet for an example.) NOTE: Please do not send original receipts to the department as they will not be returned and should be retained for your records. OPTIONS FOR PROVIDING THE INFORMATION You may email, fax or mail the form and documentation to the department. When emailing the form and documentation, use a DEX-93, Personal Income Tax Correspondence Sheet and email the information to [email protected] When faxing the form and documentation, use a DEX-93, Personal Income Tax Correspondence Sheet and fax the information to 717-783-5823. When mailing the form and documentation, mail it to the department at: PENNSYLVANIA DEPARTMENT OF REVENUE PO BOX 280501 HARRISBURG PA 17128-0501 NOTE: Emailing or faxing the form and documentation to the department will reduce the processing time of your return. REV-775 PRINT 1
Extracted from PDF file 2019-pennsylvania-form-rev-775.pdf, last modified January 2016

More about the Pennsylvania Form REV-775 Individual Income Tax TY 2019

We last updated the Personal Income Tax Employee Business Expense Affidavit in January 2020, so this is the latest version of Form REV-775, fully updated for tax year 2019. You can download or print current or past-year PDFs of Form REV-775 directly from TaxFormFinder. You can print other Pennsylvania tax forms here.

Other Pennsylvania Individual Income Tax Forms:

TaxFormFinder has an additional 174 Pennsylvania income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form PA-40 Pennsylvania Income Tax Return
Form PA-40 PA-V PA-40 Payment Voucher
Form 40 Instruction Booklet Income Tax Instruction Booklet
Form PA-40 W-2S PA Schedule W-2S - Wage Statement Summary
PA-40 Income Tax Return

Download all PA tax forms View all 175 Pennsylvania Income Tax Forms


Form Sources:

Pennsylvania usually releases forms for the current tax year between January and April. We last updated Pennsylvania Form REV-775 from the Department of Revenue in January 2020.

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About the Individual Income Tax

The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.

Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!

Historical Past-Year Versions of Pennsylvania Form REV-775

We have a total of five past-year versions of Form REV-775 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2019 Form REV-775

Personal Income Tax Employee Business Expense Affidavit (REV-775)

2017 Form REV-775

Personal Income Tax Employee Business Expense Affidavit (REV-775)

2016 Form REV-775

Personal Income Tax Employee Business Expense Affidavit (REV-775)

Forms/Publications 2015 Form REV-775

Personal Income Tax Employee Business Expense Affidavit (REV-775)


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