Local Services Tax (Lst) Form - Richland Township - 2011
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1
2Richland Township
2011 Local Services Tax (LST)
Self-Employed Return
Payable To –
1. Local Services Tax
(
_________
$52 Annually or $13 Quarterly)
Richland Township
2. Penalty (5%)
_________
1328 California Rd., Suite A
3. Interest (1/2% per month)
_________
Quakertown, PA 18951
4. Total – Including any penalty
and interest due
$_________
I DECLARE UNDER PENALTY OF LAW THAT THE
INFORMATION HEREIN CONTAINED IS TRUE AND CORRECT
Due within 30 days of taxable quarter:
AUTHORIZED
SIGNATURE
th
st
Jan-Mar due Apr 30
. Jul-Sept due Oct 30
1.
3
st
st
1st Qtr. Payment
Apr-Jun due July 30
Oct-Dec due Jan 30
DATE FILED
2.
4.
Name & Address
Business Name
Social Security No.
Richland Township
2011 Local Services Tax (LST)
Self-Employed Return
Payable To –
1. Local Services Tax
$
13.00
Richland Township
2. Penalty (5%)
_________
1328 California Rd., Suite A
3. Interest (1/2% per month)
_________
Quakertown, PA 18951
4. Total – Including any penalty
and interest due
$_________
I DECLARE UNDER PENALTY OF LAW THAT THE
INFORMATION HEREIN CONTAINED IS TRUE AND CORRECT
Due within 30 days of taxable quarter:
AUTHORIZED
SIGNATURE
th
st
Jan-Mar due Apr 30
. Jul-Sept due Oct 30
1.
3
st
st
2nd Qtr. Payment
Apr-Jun due July 30
Oct-Dec due Jan 30
DATE FILED
2.
4.
Name & Address
Business Name
Social Security No.
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