Net Profits License Fee Return Form - Ohio County Kentucky
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3OHIO COUNTY KENTUCKY
Rec'd / Processed
NET PROFITS LICENSE FEE RETURN
This form must be completed in its entirety otherwise it may be returned to you and delay the filing of your Net Profits tax
Check If Applicable
FOR YEAR ENDING
Office Hours
EXTENSION REQUESTS
12 / 31 / ____
8 a.m. - 4 p.m. CT
______ ADDRESS CHANGE
Please use coupon provided
Monday - Friday
DUE DATE
______ AMENDED RETURN
(see Ord#09-2;Sec10(2))
(below) to ensure
Phone (270) 298-4410
04 /15 / ____
______ NO ACTIVITY
timely & accurate credit
Fax (270) 298-4409
ACCT NO.
Web Address
ohiocounty.ky.gov/departments/octax.htm
Name
Email:
Contact
_______________
octaxclerk@ohiocountyky.gov
Address
octaxadmin@ohiocountyky.gov
Phone No.__________________________
Ext._____________
Fax No._______________
* PLEASE ANSWER ALL QUESTIONS*
A.
Nature of Activity /Business Entity:___________________
(if new account) DATE Activity Began IN Ohio County:______________________
B.
Principle owner/administrative officer:________________________________
Address:_______________________________________
C.
BUSINESS TYPE:
SOLE PROPRIETOR________
C-CORP________
S-CORP________ PARTNERSHIP________
FIDUCIARY________ OTHER________
D.
Did you have EMPLOYEES in Ohio County this year?__________
If YES, was EMPLOYEES' tax withheld and remitted?_______________
E.
*DID YOU FILE A FEDERAL TAX RETURN THIS YEAR? YES_____ NO_____ (CHECK ONE)
If YES, attach applicable schedule
F.
*FINAL RETURNS - Give DATE Activity / Operations ended IN OHIO CO._______________
CHECK ONE:
Dissolution________________
Sale/Transfer?__________
If SOLD or TRANSFERRED give Name and Address of new owner:__________________________________________________________
G.
Basis upon which tax return is prepared:
Cash________ Accrual________
H.
During the past year did Federal Authorities change or propose to change net income reported for that year or any prior year? __________
If YES, which year(s) was adjusted?
(Attach statement of changes)
*Complete Worksheet on back BEFORE completing the section below *
20.
20.
Enter ADJUSTED NET PROFIT (From line 15 on the back of this form)
21.
21.
%
Enter PERCENTAGE from Line 18 or 19
22.
22.
Net Profits Subject to License Fee (Line 20 X Line 21)
23.
23.
Ohio County License Fee Due (Line 22 X 1%)
24.
LESS Credit / Estimated Payment
24.
(Circle "Credit" or "Estimated Payment" if Applicable )
25.
25.
Balance of License Fee Due (Line 23 minus Line 24)
26.
26.
PENALTY - 5% per month, not to exceed 25% - MINIMUM $25
Penalty due on amount owed at original due date, unless full payment was paid timely.
If Estimated Payment or Account Credit was less than amount owed, figure Penalty on difference.
27.
27.
INTEREST - 12% per annum
Calculate interest on amount owed on Line 25 from original due date.
28.
28.
Farm Labor at 1% of gross amount paid
OR
If tax was remitted "Quarterly" please check_______
29.
Total Amount Due ----Minimum Payment - $0 due if less than $10.00 owed
29.
Maximum Payment - $10,000.00 (excluding penalty & interest)
30.
30.
Underpayment Penalty (If line 29 is greater than $5,000 see instructions-available online)
31.
Overpayment
31.
**Refund
Credit
**($50.00 (+) eligible for Refund - 'Less than' $50.00 will be credited to the account) see Ord 2009-2 (Sec 10)
I hereby certify, under penalty of perjury, that the statements made herein and any supporting schedules are true, correct, and complete to the best of my knowledge.
/
/
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Preparer Signature (Return must be signed.)
Date
Taxpayer Signature (Return must be signed.)
Date
Print Name
Federal ID
Print Name
Address
Phone No.
Title
Social Security No.
Email:
Email:
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