2011 Uk Income Tax Seminars Program Registration Form - Kentucky Page 4

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September 2011
4
Kentucky Tax Alert
General Income Tax Seminars–2011
2011 UK Income Tax Seminars Program Registration Form
Name ___________________________________________________________________________________
Company ________________________________________________________________________________
Address __________________________________________________________________________________
City ____________________________________ State ______________________ ZIP __________________
Phone (
) _______________________________Fax (
)______________________________
Last four digits of Social Security number _________
(Social Security number required to verify CEU credits)
Payment must accompany registration! Please duplicate this form for multiple registrations.
Payment Method:
Check
Visa
MasterCard
Discover
Make Checks Payable To:
UK Income Tax Seminar, 301 C.E. Barnhart Building, Lexington, KY 40546-0276
Phone 888-808-3303 or 859-252-3769 FAX 859-225-9043
(Faxed registrations without a credit card number will not be accepted!)
Card Account Number ____________________________ Expiration Date _____/_______
Amount _______________________ Cardholder Name ________________________________
Signature ____________________________________
DO NOT supply credit card information via email for security purposes.
Kentucky Tax Alert comments and suggestions should be addressed to the Offi ce of Income Taxation/Training
Branch, Finance Cabinet, Department of Revenue, Frankfort, Kentucky, (502) 564-0937.
S
L. B
, Governor
TEVEN
ESHEAR
L
F
, Secretary
ORI
LANERY
Finance and Administration Cabinet
T
B. M
, Commissioner
HOMAS
ILLER
Department of Revenue
Cindy Lanham, Editor
Sarah Gilkison, Publications Coordinator
Production/Design: Support Services
The Kentucky Department of Revenue does not discriminate on the basis of race, color, national origin, sex, religion,
age or disability in employment or the provision of services.
The Department of Revenue can be found at

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