Employers Quarterly Return Payroll/occupational Tax Withheld Form - City Of Franklin, Ky

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CITY OF FRANKLIN, KY 
EMPLOYERS QUARTERLY RETURN 
PAYROLL/OCCUPATIONAL TAX WITHHELD 
ACCOUNT #____________ 
 
 
QUARTER ENDING 12‐31‐__   DUE BY 1‐31‐__      
 
 
 
 
 
Business Name   
________________________________   
 
 
Address   
 
________________________________   
 
 
 
 
City, State and Zip 
________________________________   
 
 
 
 
 
 
 
 
 
 
________ 
TOTAL # OF EMPLOYEES
 
 
 
 
         
 
 
        
________ 
TOTAL # OF EMPLOYEES SUBJECT TO FEE
 
1. Total Gross Salaries, Wages, Commissions and    
 
 
 
 
Other Compensation Paid 
 
 
 
 
 
______________ 
2. Less Compensation Paid for Services Outside Franklin   
(_____________) 
3. Taxable Earnings In Franklin City (Line 1 Minus Line 2)   
______________ 
4. City Tax Withheld (Line 3 X 1%) 
 
 
 
 
______________ 
5. Interest @ 1% Per Month From Due Date   
 
 
______________ 
6. Penalty @ 5% Per Month (minimum $25.00) 
 
 
______________ 
7. Total Amount Due 
 
 
 
 
 
 
______________ 
 
 
SIGNATURE 
 
 
 
 
TITLE   
 
 
 
DATE 
I hereby certify, under penalty of perjury, that the statements made herein and in any supporting schedules are true, 
correct and complete to the best of my knowledge. 
 
1. A copy of this form must accompany your payment. You should retain a copy for your records. 
2. If this business has changed ownership, or tax entity, please notify this office immediately. 
3. Please make any necessary mailing address changes to this form. 
4. This form must be returned with explanation even if you had no employees during this tax period. 
5. The employer must file with the City a copy of the employees W‐2 Wage Tax Statement any 1099s for services 
performed during the calendar year on or before the last day of February each year. 
6. THIS RETURN MUST BE FILED WHETHER OR NOT YOU HAD EMPLOYEES DURING THIS 
PERIOD.  IF NOT, PLEASE MARK “NONE” ON THE FORM.  A $25.00 LATE FILING FEE WILL 
APPLY IF NOT REMITTED. 
 
PAYMENT SHOULD BE MADE PAYABLE TO: 
CITY OF FRANKLIN, KY.  
        
PO BOX 2805 
       
FRANKLIN, KY  42135 
 
Contact information: 
daniel.reetzke@franklinky.org    (270)586‐4497 phone   (270)586‐9419 fax 
 
ALL FORMS ARE AVAILABLE ONLINE AT 

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