City Employee Withmqlding Tax Form - State Of Kentucky

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TBIS RETURN MUST BE FILED WHETBERYOU HAD EMPLOYEES OR NOT DURING TIIIS PERIOD.
I.
Total Gross SaIaries, Wages Commissions and
_I___)
Less Compensation Paid for Services
-B
(Line 4 Minus Line 5)
PenaIty - 10.0% after 30 days past due +
(Minimnm $25.00)
L 1
hereby cenify that this information
CITY EMPLOYEE WITHMQLDING TAX
CITY OF BOWLING GREEN KY
PO BOX 1410
BOWLING GREEN KY 42102-1410
(270) 393-3000
1.
Other Compensation Paid
2.
Outside Bowling Green
3.
Taxable Earnings (Line 1 Minus Line 2) -_)
4.
City Tax Due (Line 3 x 1.5%) -b
5.
Less Credits or Prepayments -b
6.
Net Tases Due On or Before Due Date +
Interest - 1.5 % Per Month after due date +
8.
9.
TOTAL TAX, PENALTY AND INTEREST+
10. Number of Employees In Bowling Green
On Last Payroll In This Period ____)
I
is true and correct:

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