Form 1099-Sf - Statement Of Non-Employee Compensation - Louisville Metro Revenue Commission

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FORM
LOUISVILLE METRO REVENUE COMMISSION
1099
-SF
STATEMENT OF NON-EMPLOYEE COMPENSATION
CHECK IF CHANGE IN ADDRESS IS BELOW
Name
Address
City
State
Zip
Federal ID
SSN
Phone
Ext
CHECK IF 100% OF COMPENSATION PAID WAS FOR SERVICES PERFORMED IN
ACCOUNT NO
LOUISVILLE METRO, KY
(See Reporting Requirements on Page 2)
CALENDAR YEAR
COL 1
COL 2
COL 3
COL 4
COL 5
COL 6
AMOUNT OF COL 4
TOTAL NON-EMPLOYEE
NAME
STREET ADDRESS
RECIPIENT’S
EARNED IN
OCCUPATIONAL
COMPENSATION PAID
(TYPE OR PRINT)
CITY, STATE, ZIP CODE
SSN OR FID
LOUISVILLE METRO
TAX WITHHELD
INSTRUCTIONS FOR PREPARING FORM 1099-SF FOR LOUISVILLE METRO, KENTUCKY
GENERAL: Payor should report only those recipients who receive $600.00 or more for services performed in Louisville Metro, Kentucky.
(Entry in Column 5 is greater than or equal to $600.00.)
COLUMN 1: Enter the name of the recipient who received non-employee compensation. (Enter legal name, do not use D/B/A’s.)
COLUMN 2: Enter the mailing address of the recipient of the non-employee compensation. (Home address preferred.)
COLUMN 3: Enter the social security number or federal identification number of the recipient.
COLUMN 4: Enter the total amount of non-employee compensation paid to the recipient during the tax year.
COLUMN 5: Enter the amount of non-employee compensation which was paid to the recipient for services performed within
Louisville Metro, Kentucky. (Do not complete for any recipient compensated under $600.00.)
COLUMN 6: Enter the amount of occupational tax that was withheld and remitted to the Louisville Metro Revenue Commission
on behalf of the recipient of the non-employee compensation. Local taxes should not be withheld from non-employee
compensation. However, if you did withhold in error, please record amount in Column 6.
Under penalties of perjury, I declare that I have examined this return, including accompanying documents and, to the best of my knowledge and belief, it is
true, correct, and complete.
SIGNATURE: _________________________________________________________________________
DATE: _______________
PRINT NAME: ____________________________________________________________
TITLE: ____________________________
MAILING ADDRESS: P.O. BOX 35410 • LOUISVILLE, KENTUCKY 40232-5410
Telephone: (502) 574-4860 • • Fax: (502) 574-4818 • • TDD: (502) 574-4811

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