Scranton Self-Employment Local Services Tax Return

Taxpayer Name: Taxpayer SS#: Taxpayer Address:

Scranton Self-Employment Local Services Tax Return

1st Quarter due by last working day of April

Business Name: EIN(if applicable): BP Acct #:

1. Tax Due ($39 per Qtr--$3 per week)

$

Make Checks Payable & Remit to:

2. Penalty (5%) if paid after due date

$

Collector of Taxes

3. Interest (1% for each month late)

$

4. Total Payment Enclosed (Add lines 1 through 3)

$

100 The Mall at Steamtown Unit 216 Scranton PA 18503

RETURN THIS PORTION WITH YOUR PAYMENT

Taxpayer Name: Taxpayer SS#: Taxpayer Address:

Scranton Self-Employment Local Services Tax Return

2nd Quarter due by last working day of July

Business Name: EIN(if applicable): BP Acct #:

1. Tax Due ($39 per Qtr--$3 per week)

$

2. Penalty (5%) if paid after due date

$

3. Interest (1% for each month late)

$

4. Total Payment Enclosed (Add lines 1 through 3)

$

Make Checks Payable & Remit to: Collector of Taxes

100 The Mall at Steamtown Unit 216 Scranton PA 18503

RETURN THIS PORTION WITH YOUR PAYMENT

Taxpayer Name: Taxpayer SS#: Taxpayer Address:

Scranton Self-Employment Local Services Tax Return

3rd Quarter due by last working day of October

Business Name: EIN(if applicable): BP Acct #:

1. Tax Due ($39 per Qtr--$3 per week)

$

2. Penalty (5%) if paid after due date

$

3. Interest (1% for each month late)

$

4. Total Payment Enclosed (Add lines 1 through 3)

$

Make Checks Payable & Remit to: Collector of Taxes

100 The Mall at Steamtown Unit 216 Scranton PA 18503

RETURN THIS PORTION WITH YOUR PAYMENT

Taxpayer Name: Taxpayer SS#: Taxpayer Address:

Scranton Self-Employment Local Services Tax Return

4th Quarter due by last working day of January

Business Name: EIN(if applicable): BP Acct #:

1. Tax Due ($39 per Qtr--$3 per week)

$

2. Penalty (5%) if paid after due date

$

3. Interest (1% for each month late)

$

4. Total Payment Enclosed (Add lines 1 through 3)

$

Make Checks Payable & Remit to: Collector of Taxes

100 The Mall at Steamtown Unit 216 Scranton PA 18503

RETURN THIS PORTION WITH YOUR PAYMENT

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