Form LST­S  Local Services Tax
                                                                                Due Date                                          Quarter
PO Box 559                                   File Each Quarter 
Irwin PA 15642                                                                  1/31/2024                                                  4
Business Name and Address
                                             Total Number Employees . . ...............................................
                                             1.                Tax Remitted                                                     ,            .
                                             2.                Penalty/Interest                                                 ,            .
                                                               ( % per month)
Municipality                                 3.                Total Tax Paid 
                                                                                                                                ,            .

PSD Code:                FEIN:  ­
                                                                                        Business.KeystoneCollects.com

                                             13820123004013124000000000000000000001

                               Form LST­S  Local Services Tax                   Due Date                                          Quarter
PO Box 559                          File Each Quarter                           10/31/2023                                                 3
Irwin PA 15642
Business Name and Address
                                             Total        Number Employees . . ...............................................
                                             1.                Tax Remitted                                                     ,           .
                                             2.                Penalty/Interest                                                 ,           .
                                                               ( % per month)
Municipality                                 3.                Total Tax Paid 
                                                                                                                                ,           .

PSD Code:                FEIN:  ­                                                       Business.KeystoneCollects.com

                                             13820123003103123000000000000000000002 

                               Form LST­S  Local Services Tax                   Due Date                                          Quarter
PO Box 559                          File Each Quarter                           7/31/2023                                                  2
Irwin PA 15642
Business Name and Address
                                             Total        Number Employees . .................................................
                                             1.                Tax Remitted                                                     ,           .
                                             2.                Penalty/Interest                                                 ,           .
                                                               ( % per month)
Municipality                                 3.                Total Tax Paid 
                                                                                                                                ,           .

PSD Code:                FEIN:  ­                                                       Business.KeystoneCollects.com

                                             1382012300207312300000000000000000000  8

                               Form LST­S  Local Services Tax                   Due Date                                          Quarter
                                    File Each Quarter                           4/30/2023                                                  1
PO Box 559
Irwin PA 15642
Business Name and Address
                                             Total         Number Employees ................................................... 
                                             1.                Tax Remitted                                                     ,           .
                                             2.                Penalty/Interest                                                 ,           .
                                                               ( % per month)
Municipality                                 3.                Total Tax Paid 
                                                                                                                                ,           .

PSD Code:                FEIN:  ­                                                       Business.KeystoneCollects.com

                                             13820123001043023000000000000000000003 

Instructions: File and make payment online at www.KeystoneCollects.com
1. If not filing online, a business with one or more employees working within the taxing district must
return a complete LST-S Form on or before the quarterly due date. Multiple workplaces located in
different taxing jurisdictions MUST be reported separately.
2. Report Federal Tax Identification Number (FEIN), workplace location (municipality), Municipal PSD
(political subdivision) code, employee tax payment information and number of employees whose LST tax
was withheld.
3. Make check payable to Keystone Collections Group.
             -OR-
File and make payment ONLINE at www.KeystoneCollects.com

Instructions: File and make payment online at www.KeystoneCollects.com
1. If not filing online, a business with one or more employees working within the taxing district must
return a complete LST-S Form on or before the quarterly due date. Multiple workplaces located in
different taxing jurisdictions MUST be reported separately.
2. Report Federal Tax Identification Number (FEIN), workplace location (municipality), Municipal PSD
(political subdivision) code, employee tax payment information and number of employees whose LST tax
was withheld.
3. Make check payable to Keystone Collections Group.
             -OR-
File and make payment ONLINE at www.KeystoneCollects.com

Instructions: File and make payment online at www.KeystoneCollects.com
1. If not filing online, a business with one or more employees working within the taxing district must
return a complete LST-S Form on or before the quarterly due date. Multiple workplaces located in
different taxing jurisdictions MUST be reported separately.
2. Report Federal Tax Identification Number (FEIN), workplace location (municipality), Municipal PSD
(political subdivision) code, employee tax payment information and number of employees whose LST tax
was withheld.
3. Make check payable to Keystone Collections Group.
             -OR-
File and make payment ONLINE at www.KeystoneCollects.com

Instructions: File and make payment online at www.KeystoneCollects.com
1. If not filing online, a business with one or more employees working within the taxing district must
return a complete LST-S Form on or before the quarterly due date. Multiple workplaces located in
different taxing jurisdictions MUST be reported separately.
2. Report Federal Tax Identification Number (FEIN), workplace location (municipality), Municipal PSD
(political subdivision) code, employee tax payment information and number of employees whose LST tax
was withheld.
3. Make check payable to Keystone Collections Group.
             -OR-
File and make payment ONLINE at www.KeystoneCollects.com