Net Profit License Fee Return Form - City Of Hopkinsville
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1
2CITY OF HOPKINSVILLE
P O Box 707
Hopkinsville, Kentucky 42241-0707
NET PROFIT LICENSE FEE RETURN
Calendar Year Ended Dec. 31 _____, or Fiscal Year Ended _________________, 20_____
Federal ID #
Social Security #
City Acct #
Name
Address
City, State, Zip
Phone
Final Return (check to inactivate account)
Final Return (check only to inactivate account)
PLEASE SEE INSTRUCTIONS ON BACK
1. Gross Receipts/Sales and Other Income per
1
attached Federal Return
2. If Line 1 is less than $25,000.00, check here. No
2
renewal fee required. Copy of Federal return must
be attached as documentation of gross receipts
COPY OF APPLICABLE
3. Total Deductions per Federal Return
3
FEDERAL RETURN
(Cost of Goods Sold + Expenses)
OR SCHEDULE
4. Net Income per Federal Form
4
MUST BE ENCLOSED
Fed Sch.C (1040)
5. Add Expenses Not Deductible (Sect B line 24)
5
Fed Sch. E (1040)
Fed 1065
6. Total (Add line 5 to line 4)
6
Fed 1120S
Fed 1120
7. Deduct Income Not Subject under Ordinance
7
Fed 1120 REIT
(Section B line 30)
8. Adjusted Income ( Subtract line 7 from line 6)
8
%
9. Business Allocation Percent ( Section C- page 2)
9
FEDERAL RETURN
SHOULD INCLUDE:
10. Net Profits subject to License fee
10
1. Cost of Goods Sold Schedule
(Multiply line 8 by line 9)
2. Schedule of "Other Deductions"
11. License fee- 1.5% of Line 10 (Minimum Fee $250.00)
11
Maximum fee $10,000.00
Business Classification
12. Interest 1% per month
12
(Check one)
( ) Corporation ( ) Fiduciary
13. Penalty - 5% per month/ not to be less than $25.00
13
( ) Partnership
Maximum penalty 25% of total license fee
( ) Sole Propreitorship
14. Total ( Add lines 11- 13)
14
( ) Other
Make Check Payable to:
City of Hopkinsville
15. Less Credits:
a. Estimated Payments
15
P O Box 707
b. Overpayment from Prior Year
16. Total Amount Due (Subtract Line 15 from Line 14)
Hopkinsville, Ky 42241-0707
16
*
Phone 270-890-0221
*If Overpayment, indicate amount to be Refunded ______________
or Applied to Next Year ________________
Under penalties of perjury, I declare that I have examined this return, including accompaning schedules and
statements, and to the best of my knowledge and belief, it is true, correct and complete.
Signature of Taxpayer___________________________ Title ___________________ Date ____________ Phone_____________
Preparer's Signature ___________________________
Title ___________________ Date ____________ Phone _____________
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