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30 2nd Qtr - Ends 06/30 - Due 07/31 3rd Qtr - Ends 09/30 - Due 10/31 4th Qtr - Ends 12/31 - Due 01/31 Name and Address of Employee Tax Withheld Page Total: Quarter Total: PLEASE MAKE CHECK PAYABLE AND REMIT TO: Keystone Collections Group 546 Wendel Road Irwin, PA 15642 Phone: (724) 978-0300 Fax: (724) 978-0339.

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