Occupational License/payroll Tax Application Form - County Of Boone & City Of Florence
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1
2County of Boone & City of Florence
Occupational License/Payroll Tax Application
Effective December 2009
Instructions:
City of Florence
(Round to
City of Florence
A. Applicants are required to complete this application in full
Estimated Sales/
nearest $)
before conducting business. Subject to approval
Receipts During First
G.
Estimated Sales/Receipts During
B. Applicants are required to pay a $25.00 Boone County
Year of Business
First Year of Business
Occupational License fee with this application.
(Item G)
$
C. When conducting business in the City of Florence, please
Rate (Multiply by)
0.001
comply with the City of Florence fee calculated at the right
Total Remittance:
and remit both the Boone County fee AND the City of
Florence fee.
H.
City of Florence
$
D. If construction or a use group change is being performed
(From Fee Calculation)
City of Florence Fee
within Boone County, KY, a permit is required from the
Amount (Enter This
Boone County Building Department (859) 334-2218
Penalty 12%
$
Amount on Item H.)
E. If construction, the Occupational License Department
Interest 1% per month
$
Minimum Fee $40.00
requires the Contractor to supply a complete list of
Maximum Fee
Subcontractors containing Name, Address and Phone
$10,000.00
Number. The Occupational License may be delayed if this
I.
Boone County
$ 25.00
information is not supplied.
According to an opinion (OAG-85-1) of the
F. The normal processing time for an application is ten to
J.
Total (All Lines)
$
Kentucky Attorney General, the responses
fifteen working days, if the application is completed
that you make to questions 1, 2A, and 8
correctly. Upon approval, you will receive correspondence
below are to be provided to anyone upon
which will include your account number.
request, pursuant to the “Kentucky Open
Records Law”
*Note: Contractor labor must be licensed individually*
.
1. Legal Name of Business or Applicant if Sole Proprietor:
2.
Doing Business As or Trade Name (If applicable):
3. Physical Location or Job Site/ Contractor working in the City of Florence, or Boone County (Must list location or various if many):
Phone Number:
4. Mailing Address (or Residence if applicable):
Phone Number
5. Business Entity (Select One):
Sole Proprietor
Partnership
Corporation
S Corp
LLC – Individual
LLC – Partnership
Non Profit *
Other
PSC (Public Service Corp)
* NOTE: Non Profit must attach 501C (3) Determination Letter to be tax-exempt
6. Federal Tax Identification Number:
If self employed, provide owner Social Security Number
7. If Individual, your year end is 12/31.
Corporations, Partnership, or Non Profit must provide Fiscal Year End:
(MM/DD/YY)
8. Date Business will begin in City of Florence and/or Boone County, KY
:
Est. Number of Employees:
(
Working in Boone County/Florence)
9. Do you or will you use “leased” employees?
Yes
No
If yes, Provide the name, address and phone number of leasing agency:
10. Describe in DETAIL the nature of the business:
11. Is this business a Sexually Oriented Business as defined by Boone County Ordinance 07-06 and/or City of Florence Ordinance 0-2-07
Yes
No (if yes please contact the County and/or City for additional licensing requirements)
To Be Completed by
12. Will alcohol be sold and/or served at this business location?
Yes
No
Tax Agency
13. Are you a contractor doing work in Boone County, whose company is located outside of Boone County?
Boone A/C
Yes
No
Florence A/C
14. If a contractor, are you the General Contractor?
Yes*
No
If yes, please attach a list of subcontractors you will be using.
*
Page 1 of 2 (Must complete both pages)
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Parent category: Financial