Form Lst-1 - Local Services Tax Return - Upper Merion Township Business Tax Office - 2017
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82017
2017
UPPER MERION TOWNSHIP
LST-1
LOCAL SERVICES TAX RETURN
EMPLOYER’S RETURN
PAYABLE TO:
1. Total number of individuals
UPPER MERION TOWNSHIP
reported herewith
1ST. QTR.
BUSINESS TAX OFFICE
2. Gross amount of tax
FOR PERIOD ENDING:
175 W. VALLEY FORGE RD.
collected
JANUARY 1 TO MARCH 31
KING OF PRUSSIA, PA 19406
3.
Penalty (10% of tax due)
PHONE: (610) 265-2600
(If paid after due date)
DUE DATE: APRIL 30
FAX: (610) 265-0482
4.
Interest (1
/
% per month)
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4
5. Total - including any
ALL FOUR QUARTERS ENCLOSED
LICENSE NO.
penalty and interest due
(Add lines 2, 3 & 4)
NAME AND ADDRESS
MAKE CHECKS PAYABLE TO:
UPPER MERION TOWNSHIP
I DECLARE UNDER PENALTY OF LAW THAT THE INFORMATION
HEREIN CONTAINED IS TRUE AND CORRECT.
AUTHORIZED
SIGNATURE
DATE FILED
*
INDIVIDUAL LISTING FORM (SEE INSTRUCTIONS ON BACK
)
PHONE NO.
CHECK BOX IF SELF-EMPLOYED. ALL SELF-EMPLOYED INDIVIDUALS ARE REQUIRED TO PAY LST.
GROSS WAGES
LST COLLECTED
INDIVIDUAL NAME
SOCIAL SECURITY #
TOTAL GROSS
TOTAL LST
FOR QTR
FOR QTR
WAGES TO DATE
COLLECTED TO DATE
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QUESTIONS? CALL 610-265-2600 ext 1211, 1224 or 1227.
ADDITIONAL EMPLOYEES MAY BE LISTED ON A BLANK SHEET OF PAPER AND ATTACHED TO THIS FORM.
2017
2017
SEND ORIGINAL QUARTER WITH PAYMENT AND MAKE A COPY FOR YOUR RECORDS.
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COMPUTERIZED FORMS WITH REQUIRED INFORMATION IS ACCEPTABLE.
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