725
A
__ __ __ __ __ __
*1600030270*
41A725
Kentucky Corporation/LLET Account Number
Department of Revenue
K
S
M
LLC
ENTUCKY
INGLE
EMBER
2016
I
O
I
NDIVIDUALLY
WNED
NCOME
➤ See instructions.
AND LLET R
Taxable period beginning ______________ , 201 ___, and ending ______________ , 201 __ .
ETURN
B
Check applicable box(es):
__ __ – __ __ __ __ __ __ __
C
Federal Identification Number
__ __ / __ __
Taxable Year Ending
LLET
__ __ __ – __ __ – __ __ __ __
Mo.
Yr.
Social Security Number
Receipts Method
Kentucky Secretary of State
Name of LLC
Change of Name
Gross Receipts
Organization Number
Gross Profits
Name of Owner
$175 minimum
State and Date of Organization
Number and Street
Change of Address
Nonfiling Status
Code
Principal Business Activity in KY
City
State
ZIP Code
Telephone Number
Enter Code
Qualified investment pass-through entity I nitial return
D
Check if applicable:
NAICS Code Number
Final return (Complete Part IV) Amended return (Complete Part V)
(Relating to Kentucky Activity)
(See )
Short-period return (Complete Part IV) Change of accounting period
______ ______
E
Check applicable box:
Composite return (attach Schedule CP)
Single return
PART I—KENTUCKY NET DISTRIBUTABLE INCOME
PART II—LLET COMPUTATION
1. Ordinary income (loss) ..................
1. Schedule LLET, Section D, line 1 ...
1
00
1
00
2. Tax credit recapture .......................
2
00
2. Net income (loss) from rental real
3. Total (add lines 1 and 2) ................
3
00
estate activities ...............................
00
2
4. Nonrefundable LLET credit from
3. Net income (loss) from other
Kentucky Schedule(s) K-1 ..............
4
00
rental activities ...............................
5. Nonrefundable tax credits (attach
3
00
Schedule TCS) .................................
5
00
4. Interest income ..............................
4
00
6. LLET liability (greater of line 3
5. Dividend income ............................
5
00
less lines 4 and 5 or $175
6
00
6. Royalty income ..............................
minimum) .......................................
6
00
7. Estimated tax payments ................
7. Net short-term and long-term
7
00
8. Certified rehabilitation tax credit ..
8
00
capital gain (loss). If net (loss),
9. Film industry tax credit ..................
9
00
do not include more than
10
10. Extension payment ........................
00
7
00
($3,000) ...........................................
11
00
11. Prior year’s tax credit .....................
8
00
8. Section 1231 net gain (loss) ..........
12. LLET paid on original return .........
12
00
13. LLET overpayment on original
9. Other income (attach schedule) ......
9
00
return ..............................................
13
00
10. Other deductions (attach schedule)
10
00
14. LLET due (lines 6 and 13 less lines
11. Total net distributable income
14
00
7 through 12) ..................................
11
00
(lines 1 through 9 less line 10) ......
15. LLET overpayment (lines 7
through 12 less lines 6 and 13) .....
15
00
12. Enter 100% or the apportionment
16. Credited to 2016 Interest ...............
16
00
fraction from Schedule A, Section
17. Credited to 2016 Penalty ................
17
00
I, line 12 (attach schedule) ..............
12
%
18
00
18. Credited to 2017 LLET ....................
19
00
19. Amount to be refunded .................
TAX PAYMENT SUMMARY
OFFICIAL USE ONLY
(Round to nearest dollar)
P
W
LLET
2
.00
1. LLET due (Part II, line 14)
$_____________________________
0
4
.00
2. Interest
$_____________________________
V
.00
3. Penalty
$_____________________________
A
L
.00
4. Total Payment
$_____________________________
#
1111