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Local Services Tax Direct Payment Form

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UPPER DUBLIN TOWNSHIP

801 Loch Alsh Avenue

Enter tax year here

Fort Washington, PA 19034-1697

FINANCE DEPARTMENT

Phone: (215) 643-1600, Ext.3325

Fax: (215) 542-0797

Local Services Tax

Direct Payment Form

Name:

SSN:

Address:

Payment Enclosed:

Make checks payable to:

Check Number:

UDT Finance Department

801 Loch Alsh Avenue

Fort Washington, PA 19034-1697

TAX OFFICE COPY

SEPARATE CHECKS SHOULD BE SENT FOR LST & EIT

801 Loch Alsh Avenue

Enter tax year here

UPPER DUBLIN TOWNSHIP

Fort Washington PA 19034-1697

FINANCE DEPARTMENT

Phone: (215) 643-1600 Ext.3325

Fax: (215) 542-0797

Local Services Tax

Direct Payment Form

Name:

SSN

Address

Payment Enclosed

TAXPAYER COPY

Check Number:

The Upper Dublin Township Local Services Tax (LST) is a $52 local tax due once per calendar year.

ALL INDIVIDUALS WHO PERFORM SERVICES OF ANY KIND OR ARE ENGAGED IN ANY OCCUPATION OR

PROFESSION WITHIN UPPER DUBLIN TOWNSHIP AND HAVE TOTAL INCOME GREATER THAN $12,000 FROM

ALL SOURCES ARE REQUIRED TO PAY THIS ANNUAL $52 TAX. Both residents and nonresidents shall, by

virtue of engaging in an occupation within the Township, be subject to the LST, including Philadelphia residents

and Federal employees.

The $52 LST payment should be remitted, in full, directly to the Upper Dublin Township Finance Department

no later than April 30th (30 days after the end of the 1st quarter of the current tax year). Taxpayers who become

subject to the tax after the end of the first quarter must remit this $52 tax within 30 days after the end of the quarter

in which the individual becomes subject to the tax.

Quarter:

Tax Period:

Due date (on or before):

First Quarter

April 30

January, February, March

Second Quarter

April, May, June

July 31

Third Quarter

October 31

July, August, September

October, November, December

January 31

Fourth Quarter

For more detailed information, please refer to the LST Frequently Asked Questions and/or the LST Ordinance at:

/finance/documents.aspx.

Taxpayers are entitled to receive a written explanation of their rights with regards to the assessment, audit, appeal, enforcement, refund and

collection of certain taxes administered by the Township. A written explanation entitled ''Township of Upper Dublin Taxpayer's Bill of Rights

Disclosure Statement" has been prepared for this purpose and is available without charge from the Township Finance Department.

Local Services Tax Direct Payment Form

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