Form Lst-3 - Local Services Tax Return Self Employed Page 2
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1
2PALMER TOWNSHIP
2011 LOCAL SERVICES TAX
TAXPAYER
COPY
The l ocal Services Tax is
a
locai tax due from ail individuals wtlO
are
employed
within the
taxlng jUrlsdit
tion
printed
below Ai Federal
Employees
and aii Se f
Repornng
Individuals vvt10
perform
services of any kind
or en
ja le in any
occupation
or
professions
within the
stated
Borough Township
or
School District
are
required
to
pay
a
Local Serviws Tax
Please
complete
and return the LST
i
form below with your
payment
due
If for
some maS iI
you
already paid
the tax In another
political
subdivision
or at
another
plaw
of
employment provide
this office with
proof
of
payment
and
we
will
adjust
our
records
acwrdingiy
If your
piirnary employment Jurisdiction
has the Local
Services
Tax the tax is not to be deducted from
the
secondary place
of
employment
If your
expected
annual
e
arninfls
are
less than the
exemption
amount wh h is
12 000
an
exemption
certificate may be
c o mpl e t E d
Return
the forrns belo
vv
sU1ting
such
along
vvith
a
completed exempliorl
Cb
l i i f i c et e
and
a
copy
of your
prior
yei lr lax rebJm to
our
office The
exemption
form
can
be
found
on our
website
at
WWW
paimert
vfM
om
T X ING JURISDICTION
PALMER
TO f NSHIP
ACCOUr H NUMBER
Your
cancelled check
is
suffident
proof
of
payment
Make any corrections to Name Address l
lxing
Jurisdiction and
enter your Social
Security
in boxes
provided
Make ChE cks
payable
to
PALMER
TOWNSHIP LST
Amount
paid
each
quarter
PALMER TOWNSHIP LST
3
WELLER
PLACE
EASTON
PA
18045
Qua
lier
1
0
Qua
lier
2
Quarter
3
Quarter 4
uuuuuuou
TOTAL
PAyMENTS
Remit
to
A
Keep
top
portini
fOf
your records A
V
OH lcr
ilr1 j
return
bottom
Jf
io 1 w
tr
mJr p
ym
f
Y
LST
3
TAX OFFICE
COPY
201 1 LOCAL SERVICES TAX
RETURN
SELF EMPLOYED
ENTER YOUR SOCIAL
SECURiTY
NO
Payabie
to
PALMER
TOWNSHIP
LST
3 NELLER PLACE
EASTON PA 18045
610 252
44 j
l
CCOUNT
f
i U t v 1 BER
DUE
OATE1 31
12
i
es
4
r
L I
2
PENALTY
5 Y
X Line
L
i
i
I
after Due Date
3
iNTEREST
1
2
X Line 1
I
i
I
per month after Due Date
J
j
4
Totai PENALTY
INTEREST
i
I
H i
i
add lines 2 and 3
5
OTAL
DUE
1
L
1
1
DO lOT WRITE BELOW nus UNE
r
HsT iM
8 fl
J
IBt3q
pa
rr
2 qxp
f1
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