Form Lst-3 - Local Services Tax Return Self Employed
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1
2LST 3
2011 LOCAL
SERVICES
TAX RETURN
SELF EMPLOYED
E NTEP
v
OUR
SOCIA
SEe Up
NO
PALMER TOVVNSHIP LST
3 WELLER PLACE
EASTON
PA
18045
1
COUNT
UMBEF
DUE DATE
4130
11
1
Local Services Tax
01
l
i
Annual Rate
52
4
l
c
2
PENALTY
5
X Line
1
1
i
after Due Date
t
3
INTEREST
1i2
1
X Line 1
i
per month after Due Date
f
4
Total PENALTY
INTEREST
add lines 2 and 3
j
t
5 TOTAL DUE
L
l
J
l
no NOT WRrn SELOW HilS
UN
c
c
c
7
c
THl
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i
LST
3
2011 LOCAL SERVICES TAX RETURN
SELF EMPLOYED
EN fER YOUt
Cl
FCUR 1TY
0
P a y a b i
io
PALMER TOWNSHIP
LST
3 WELLER PLACE
ElSrON
PA 18045
610
252 0440
DUE
DI T
8 1
11
ACCOUNT
NU
ABE P
1
a
Sl
4
f
i
f
2
PENALTY
5
X Line L
i
i
I
after Due Date
f
i
3
INTEREST
i 2f1o
X Line
i
t i
j
i
per month after Due Dale
1
1
j
l
4 Total PENALTY
INTEREST
i
i
add lines 2 and 3
i
5
OTAL
DUE
L
1
L
J
00 NOT
WRITel
H LOW nus
UNF
U tH 2
iJ
E
F
Sr
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t
1iEft
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LST 3
2011 LOCAL
SERVICES
TAX RETURN
SELF EMPLOYED
ENTER iOUF
CL L SeCuRiTY
o
Payable
to
PAUvlER TOWNSHiP LST
3 VVELLER PLN E
EASTON
PA 18045
610
252
0440
J
CCOUNT NUMBER
DUEOATE
1Ci31il1
1
Local Services Tax
j
T T
T j
Annual Rate
52 4
1
2
PENALTY
5
1
X
i
r
after Du
e
D ate
L
l
i
l
3
INTEREST
1 2
X Line
L
1
i
i
i
per month alter Due Date
f
l
4
Total PENALTY
iNTEREST
i
j
add lines 2 and 3
I
I
I
5
TOTAL
DUE
Sl
i
1
I
s
ff
t
fJ
r
ftM B
Wf
M
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00 NO
WRITE BELOW HUS LiNE
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