THE CITY OF PADUCAH, KY
2016 ANNUAL LICENSE TAX APPLICATION
GENERAL INSTRUCTIONS:
ALL ITEMS ON THIS APPLICATION MUST BE ANSWERED. FAILURE TO DO SO WILL DELAY THE PROCESSING OF YOUR APPLICATION
AND COULD RESULT IN A PENALTY CHARGE. INSTRUCTIONS ARE PROVIDED FOR YOUR ASSISTANCE.
Type of Business___________________________________________
PLEASE PRINT OR TYPE ALL ANSWERS
1. NAME OF BUSINESS______________________________________________________________________________________________________________________________
2. MAILING ADDRESS____________________________________________________________CITY________________________________STATE_______ ZIP________________
3. BUSINESS PHONE: (
) _______________________________ FAX: (
) _______________________________
4. OWNERSHIP
PROPRIETORSHIP
(OWNER’S SSN)
___________________________________________________________________________
PARTNERSHIP
(PARTNER’S NAME & SSN)
___________________________________________________________________________
CORPORATION
(PRESIDENT’S NAME & FEIN)
___________________________________________________________________________
5.
DO YOU HAVE EMPLOYEES WORKING IN PADUCAH?
YES
NO
IF YES, UNDER WHAT COMPANY NAME IS PAYROLL PAID? _______________________________________
6. PADUCAH LOCATION (
) AND PHONE IF DIFFERENT FROM ABOVE_________________________________________
S
7. DO YOU LEASE THE PROPERTY WHERE THE BUSINESS IS LOCATED?
YES
NO
8. CALCULATIONS:
A. TOTAL GROSS RECEIPTS (
)
CALENDAR YEAR
A$__________________
SEE INSTRUCTIONS
OR
RECEIPTS BASED ON PERIOD ___________ TO __________ FISCAL YEAR
B. A
D
LLOWABLE
EDUCTIONS
SALES TAX
$_____________________
RETURNS
$_____________________
LIQUOR SALES
$_____________________
UNCOLLECTABLE
$_____________________
OUTSIDE CITY
SEE INSTRUCTIONS FOR APPORTIONMENT
ON BACK
B $________________________
C. TOTAL GROSS RECEIPTS SUBJECT TO LICENSE FEE (
A
B) OR (
6
)
C $________________________
LINE
MINUS LINE
TOTAL FROM LINE
ON BACK IF APPORTIONMENT REQUIRED
D. LICENSE FEE
UP TO $3,500,000 MULTIPLIED BY __________________
(LINE C MULTIPLIED BY RATE)
(EXCESS MULTIPLIED BY .00005)
MINIMUM FEE _____________
D $_______________________
E. PENALTY ____ PERCENT OF FEE (
)
E $________________________
SEE INSTRUCTIONS ON BACK
.
___
(
F
INTEREST
PERCENT OF FEE
)
F $________________________
SEE INSTRUCTIONS ON BACK
G. TOTAL DUE
MAKE CHECK PAYABLE TO
CITY OF PADUCAH
G $________________________
(ADD LINE D+E+F)
AND MAIL TO
P O BOX 2697
PADUCAH, KY 42002-2697
PHONE (270) 444-8513
IF NO LONGER IN BUSINESS, ENTER CLOSING DATE
______/_______/_______
I AFFIRM THAT THIS RETURN (INCLUDING ANY ACCOMPANYING STATEMENTS) HAS BEEN EXAMINED BY ME, AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, IS A
TRUE, CORRECT AND COMPLETE RETURN, MADE IN GOOD FAITH, PURSUANT TO THE ORDINANCE ADOPTED DECEMBER 2, 1947, AS AMENDED AND THE REGULATIONS
ISSUED UNDER AUTHORITY THEREOF.
_________________________________________________
____________________________________________
________________________
SIGNATURE OF OWNER/PARTNER/CORPORATE OFFICER
NAME/PREPARED BY
DATE
YOUR APPLICATION MUST BE SIGNED
THE CITY OF PADUCAH WILL NOT ISSUE A BUSINESS LICENSE TO ANY BUSINESS SUBMITTING AN APPLICATION THAT IS NOT
ACCOMPANIED BY THE CORRECT FEDERAL TAX FORM AND PROPER PAYMENT.