Employers LST Annual Summary

Southwest Regional Tax Bureau
Employer Annual
Local Services Tax Summary Report
Year End - Due February 28th

Click here to download and print Employer LST Year End Summary Forms in PDF format

Or, you can fill in and print the form below. (Please note that any information that you type into this form will NOT BE SAVED!)

Employer's Local Service Tax Annual Reconciliation

Year End - Due February 28th

This form must accompany W-2 forms or a complete detailed listing of all employees employed at this location.

(Please see Pennsylvania Act 511 and Act 222 for reference to Local Services Tax.)

Account Number:
Employer Name:
Address:

City/State/Zip:
Phone Number:

1. Total Number of Employees:
2. Total Amount Paid:	$

Under penalties of perjury, I declare that I examined this return including accompanying schedules and statements, and to the best of my knowledge are true and correct.
Signature:
Date:

Please make checks or money orders payable to: Southwest Regional Tax Bureau (S.W.R.T.B.)

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This page last modified on 4/7/08