Form LST­S  Local Services Tax
                                                                                  Due Date                                        Quarter
PO Box 559                                   File Each Quarter 
Irwin PA 15642                                                                  1/31/2025                                                  4
Business Name and Address
                                             Total Number Employees . . ...............................................
                                             1.                Tax Remitted                                                     ,            .
                                             2.                Penalty/Interest                                                 ,            .
                                                               ( % per month)
Municipality                                 3.                Total Tax Paid 
                                                                                                                                ,            .

PSD Code:                FEIN:   ­

                                             1382012 00401312 000000000000000000004 5                                                         8

                               Form LST­S  Local Services Tax                     Due Date                                        Quarter
PO Box 559                          File Each Quarter                           10/31/2024                                                 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:  ­

                                             1382012 00310312 00000000000000000000  4 4                                                       9

                               Form LST­S  Local Services Tax                     Due Date                                        Quarter
PO Box 559                          File Each Quarter                           7/31/2024                                                  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:  ­

                                             1382012 00207312 00000000000000000000  4 4                                                       5

                               Form LST­S  Local Services Tax                     Due Date                                        Quarter
                                    File Each Quarter                           4/30/2024                                                  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:  ­

                                             1382012 00104302 000000000000000000004 4                                                         0 

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