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Wage Tax refund form (commissioned employees)

Commissioned (not hourly or salaried) employees can use this form to apply for a refund on Wage Tax. You can also use our online refund forms, for faster and more secure processing. This step-by-step video tutorial will walk you through the process of submitting a Wage Tax refund through the Philadelphia Tax Center.

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 this form 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
2023 Wage Tax refund petition (commissioned employees) PDF Commissioned (not hourly or salaried) employees can use this form to apply for a refund on 2023 Wage Tax. January 31, 2024
Wage Tax refunds: Employer certification template, dates and locations worksheet (non-residents only) docx Use this instruction sheet, employer certification letter template, and cover page when requesting a non-resident Wage Tax refund. It allows your employer to verify–with a signature–the dates and locations you entered in the Date and Locations Template (pages 1-6). March 6, 2024
2023 Dates and Locations spreadsheet (non-residents only) xlsx Use this spreadsheet (Excel) to provide the complete dates and locations where you were required to work outside Philadelphia if applying through the Philadelphia Tax Center. Use the dropdown menu at the top of the file to choose a date applicable to your petition. February 7, 2024
2022 Wage Tax refund petition (commissioned employees) PDF Commissioned (not hourly or salaried) employees can use this form to apply for a refund on 2022 Wage Tax. February 6, 2023
2022 Wage Tax refund Dates and Locations Template (non-residents only) PDF Use this spreadsheet template and cover page; include them 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 (pages 2-5). March 3, 2023
2021 Wage Tax refund petition (commissioned employees) PDF Commissioned (not hourly or salaried) employees can use this form to apply for a refund on 2021 Wage Tax. February 16, 2022
2020 Wage Tax refund petition (commissioned employees) PDF Commissioned (not hourly or salaried) employees can use this form to apply for a refund on 2020 Wage Tax. February 4, 2021
2019 Wage Tax refund petition (commissioned employees) PDF Commissioned (not hourly or salaried) employees can use this form to apply for a refund on 2019 Wage Tax. December 18, 2019
2018 Wage Tax refund petition (commissioned employees) PDF Commissioned (not hourly or salaried) employees can use this form to apply for a refund on 2018 Wage Tax. February 19, 2019

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