Do I need a notary for the Local Services Tax Exemption Certificate?

No. The certificate has no notary block. The applicant signs and dates it; the document does not request a notarized or sworn attachment.

What supporting documents should I include?

The documents depend on the exemption reason. The form lists pay statements, a prior-year W-2 or tax schedules, or military orders and disability documentation as applicable.

What information does the certificate ask for?

It requests personal and employer details, the reason for exemption, employment information for the tax year, and a signed and dated declaration.

Roaring Spring, PA · Blair County

No notary required

Local Services Tax Exemption Certificate

This certificate lets employees request a Local Services Tax exemption or refund and is submitted with supporting documents to the collecting tax office.

What this form is

Use this certificate to request an exemption from or refund of the Local Services Tax for a tax year. It asks for personal and employer information, the reason for the exemption, and employment details; supporting documents depend on the reason selected. The application says to present a copy and all necessary supporting documents to the tax office collecting the tax, and to sign and date the application.

Who needs it

Employees seeking a Local Services Tax exemption or refund can use this certificate and provide supporting documents for their stated reason.

How to submit it

Present a copy of the application and all necessary supporting documents to the tax office charged with collecting the Local Services Tax.

About notarization

This certificate has no notary block; the applicant signs and dates it, and the document does not request a notarized or sworn attachment.

How to submit this form

1
Download the Certificate
Download the Local Services Tax Exemption Certificate PDF.
2
Complete the Application
Enter your personal and employment information and select the reason for exemption.
3
Gather Supporting Documents
Attach the documents listed for your selected exemption reason.
4
Sign and Submit
Sign and date the application, then present it with supporting documents to the tax office collecting the Local Services Tax.

Frequently asked questions

Do I need a notary for the Local Services Tax Exemption Certificate?: No. The certificate has no notary block. The applicant signs and dates it; the document does not request a notarized or sworn attachment.
How do I submit the Local Services Tax Exemption Certificate?: Present a copy of the application and all necessary supporting documents to the tax office charged with collecting the Local Services Tax.
What supporting documents should I include?: The documents depend on the exemption reason. The form lists pay statements, a prior-year W-2 or tax schedules, or military orders and disability documentation as applicable.
What information does the certificate ask for?: It requests personal and employer details, the reason for exemption, employment information for the tax year, and a signed and dated declaration.

Need something notarized?

This Local Services Tax Exemption Certificate doesn’t need a notary — but if you have another Roaring Spring form that does, a commissioned online notary can help.