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Wage Tax refund form (salaried employees)

Salaried employees can use these forms to apply for a refund on Wage Tax. You can also use our online refund forms, for faster and more secure processing.

Any claim for refund must be filed within three years from the date the tax was paid or due, whichever date is later. Only non-resident employees are eligible for a refund based on work performed outside of Philadelphia.

Please return these forms using the postal service to the address printed on them. Because this form contains confidential information, please do not submit it by email. Email is not a secure way of sending confidential information.

We may contact you if we need more information.

Name Description Released Format
2021 COVID EZ Wage Tax refund petition (non-residents only) PDF Non-resident, salaried employees can use this form to apply for a refund on 2021 Wage Tax for days they were required to work from home by their employer because of the coronavirus pandemic. February 16, 2022
2021 Wage Tax refund petition (salaried employees) PDF Salaried or hourly employees can use this form to apply for a refund on 2021 Wage Tax. February 16, 2022
2020 COVID EZ Wage Tax refund petition (non-residents only) PDF Non-resident, salaried employees can use this form to apply for a refund on 2020 Wage Tax for days they were required to work from home by their employer because of the coronavirus pandemic. February 4, 2021
2020 Wage Tax refund petition (salaried employees) PDF Salaried or hourly employees can use this form to apply for a refund on 2020 Wage Tax. February 5, 2021
2020 Wage Tax refund Dates and Locations Template (non-residents only) xlsx Use this template with your paper non-resident Wage Tax refund request. It allows you to list the dates and locations your employer ordered you to work outside Philadelphia. February 5, 2021
2020 Wage Tax refund Cover Page (non-residents only) PDF Include this cover page with your paper non-resident Wage Tax refund request. It allows your employer to verify –with a signature– the dates and locations you entered in the Date and Locations Template. February 5, 2021
2019 Wage Tax refund petition (salaried employees) PDF Salaried or hourly employees can use this form to apply for a refund on 2019 Wage Tax. December 18, 2019
2018 Wage Tax refund petition (salaried employees) PDF Salaried or hourly employees can use this form to apply for a refund on 2018 Wage Tax. February 19, 2019

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