PO BOX 25156
LEHIGH VALLEY, PA 18002-5156
JURIS NO.
QUARTER _____ YEAR ________
Payable to: HAB-LST
BERKHEIMER, PO BOX 25156, LEHIGH VALLEY, PA 18002-5156
LST-3 Local Services Tax Individual Return
1. Tax Due
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2. Penalty (line 1 x 0.05 )if paid after due date
3. Interest (line 1 x 0.005 ) per month after due date
4. Total Penalty & Interest (line 2 + line 3)
5. Total of Check Enclosed (line 1 + line 4)
Make Checks payable to: HAB-LST
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*LSTQ3*
The Local Services Tax is a local tax due from all individuals who are employed within the taxing jurisdiction printed below.
All Federal Employees and all Self-Reporting Individuals who perform services of any kind or engage in any occupation or
professions within the stated Borough, Township, or School District are required to pay a Local Services Tax.
Please complete and return the LST-3 form below with your payment due. If remitting the annual tax amount due in full,
please submit all returns with your payment at the time of filing. If for some reason you already paid the tax in another
political subdivision, or at another place of employment, provide this office with proof of payment and we will adjust our
records accordingly. If your primary employment jurisdiction has the Local Services Tax, the tax is not to be deducted from
the secondary place of employment.
. Your cancelled check is sufficient proof of payment.
. There will be a $29.00 cost for insufficient funds and returned payments.
. Make Checks payable to: HAB-LST
Exemption Enclosed-no tax due (check here)
WEB
You are entitled to receive a written explanation of your rights with regard to the audit,
appeal, enforcement, refund and collection of local taxes by calling Berkheimer at
610-599-3142 during the hours of 8:00 AM - 4:00 PM, Monday through Friday. Or,
you can visit our website at www.hab-inc.com. If Berkheimer is not the appointed tax
hearing officer for your taxing district, you must contact your taxing district about the
proper procedures and forms necessary to file an appeal.
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