LS-3 2020
LOCAL SERVICES TAX
CFD PERSONAL RETURN – EMPLOYEE ONLY
CITY OF PITTSBURGH
FOR PROPER CREDIT SOCIAL SECURITY NUMBER MUST BE ENTERED IN BOX BELOW Rev 10/19
Due on or before
USE BLACK INK ONLY ON THIS FORM- DO NOT STAPLE ANYTHING TO THIS FORM
If this is an annual return please check this box
LOCAL SERVICES TAX IS $52.00 PER YEAR - $13.00 PER QUARTER
1. LOCAL SERVICES TAX AMOUNT
2. INTEREST – (Interest per month 1% (0.01) )
3. PENALTY – (Penalty per month 0.5% (0.005) )
4. DEBIT / CREDIT AMOUNT - (Enter credits as negative)
EXPLAIN: ____________________________________________________
5. TOTAL AMOUNT DUE – (Add lines 1 through 4)
Make check payable to: TREASURER, CITY OF PITTSBURGH – DO NOT SEND CASH
Mail to: CITY TREASURER LS-3 – 414 GRANT ST – PITTSBURGH PA 15219-2476
A $30.00 fee will be assessed for any check returned from the bank for any reason.
If you are employed within the City of Pittsburgh and your employer HAS NOT withheld the Local Services Tax, and you expect to make over
$12,000 in the City of Pittsburgh this year, you are required to pay the tax yourself using this form. Failure to file will result in the imposition of
a penalty and interest charge.
Please provide the following information:
EMPLOYER________________________________________ PAYROLL CONTACT PERSON__________________________
ADDRESS_________________________________________ PHONE ____________________________________________
You should pay $13 per quarter for a total of $52. First quarter (January, February, and March) return is due April 30. Second Quarter
(April, May, and June) return is due July 31. Third quarter (July, August, and September) return is due October 31. Fourth quarter
(October, November, and December) return is due January 31.
Local Services Tax is $52.00 per person, per year, payable quarterly. Pennsylvania law limits total payment by one person to a
maximum of $52.00 per year regardless of the number of employers in a year. For information call 412-255-2510.
IF THIS FORM IS NO LONGER NEEDED, PLEASE COMPLETE THE FOLLOWING
A. My employer is deducting the tax.
EMPLOYER____________________________________ PAYROLL CONTACT PERSON_____________________
ADDRESS______________________________________ PHONE ________________________________________
My occupation is performed outside the City limits in (Municipality)_____________________________________
Amended Return ( ) Tax Return No Longer Needed ( )
SIGNATURE _____________________________________________
TITLE _____________________ DATE _______________________
PHONE _________________________________________________
E-MAIL ADDRESS ________________________________________
PREPARER’S NAME ______________________________________
PREPARER’S PHONE ______________________________________
I hereby certify, swear and aver that all statements herein are true and correct to the best of my knowledge and
belief, being duly apprised of my duty under the law to submit honest and complete information or be subject to the
penalties provided by law.
OMISSION OF THE ABOVE APPLICABLE INFORMATION
CONSTITUES AN INCOMPLETE RETURN
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