Form Lst-I - Individual Local Services Tax - 2016 Page 2

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Form LST­I
Due Date
Quarter
Keystone Collections Group
Individual Local Services Tax
4
PO Box 539
January 31, 2017
Irwin, PA 15642
Business Name
SSN ............................................
.
1.
Tax Remitted
,
Business Municipality
2.
Penalty/Interest
,
.
(1.25% per month)
3.
Total Tax Paid
,
.
13720115004013116000000000000000000009
Form LST­I
Due Date
Quarter
Keystone Collections Group
Individual Local Services Tax
3
October 31, 2016
PO Box 539
Irwin, PA 15642
Business Name
SSN .............................................
1.
Tax Remitted
,
.
Business Municipality
2.
Penalty/Interest
,
.
(1.25% per month)
3.
Total Tax Paid
,
.
13720115003103115000000000000000000000
Form LST­I
Due Date
Quarter
Keystone Collections Group
Individual Local Services Tax
2
PO Box 539
August 01, 2016
Irwin, PA 15642
Business Name
SSN .............................................
1.
Tax Remitted
,
.
Business Municipality
2.
Penalty/Interest
,
.
(1.25% per month)
3.
Total Tax Paid
,
.
13720115002073115000000000000000000006
Form LST­I
Due Date
Quarter
Keystone Collections Group
1
Individual Local Services Tax
May 02, 2016
PO Box 539
Irwin, PA 15642
Business Name
SSN .............................................
1.
Tax Remitted
,
.
Business Municipality
2.
Penalty/Interest
,
.
(1.25% per month)
3.
Total Tax Paid
,
.
13720115001043015000000000000000000001

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