Form Lst-3 - Local Services Tax Individual Return
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1LST-3
LOCAL SERVICES TAX INdIVIdUAL ReTURN
YEAR:
THIS FORM MUST Be FILed ANd ReTURNed eACH QUARTeR
CALCULATIONS ONLY
QUARTER:
TAXING JURISDICTION:
ACCOUNT NO.
WE
CALCULATe TAx dUe
PSD:
Enter totals from right column below and remit to HAB-LST.
If no tax is due and Exemption Certificate is enclosed, please check the box
below and remit to HAB-LST.
¸
$
1. LST Annual Rate
4......
Name
Address
$
2. Penalty
x Line 1 after Due Date...
City
State
3. Interest
x Line 1 per month after
&
$
Zip
Due Date.....................
$
4. Total Penalty and Interest (lines 2+3).........
5. Total Due (add lines 1 and 4)...................
$
LST-3
Enter information from above
Payable to: HAB-LST
BERKHEIMER, PO BOX 25156, LEHIGH VALLEY, PA 18002-5156
Check here if “yes”:
TAXING JURISDICTION:
Exemption Enclosed-no tax due
ACCOUNT NO.
WE
PSD:
Annual Rate ¸ 4.......................
Total penalty & interest..............
Total of check enclosed..............
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