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FRANKLIN COUNTY

FRANKLIN COUNTY, KENTUCKY - Quarterly report of wages paid and tax withheld.

Employer's Quarterly Return License Fees Withheld

If no wages were paid this quarter mark "NONE" and return this form with explanation.

MAIL TO: FRANKLIN COUTY

1. NUMBER OF TAXABLE EMPLOYEES

6. ADJUSTMENTS

OCCUPATIONAL TAX

(EXPLAIN ON REVERSE SIDE)

P.O. BOX 594

2. TOTAL SALARIES, WAGES, COMMISSION &

FRANKFORT, KENTUCKY 40602

7. PENALTY 10%

OTHER COMPENSATION PAID ALL EMPLOYEES

MAKE CHECKS PAYABLE TO :

3. LESS ITEMS NOT SUBJECT TO

(COMPENSATIONS

TREASURER, FRANKLIN COUNTY

8. INTEREST 1%

PER MONTH

PAID FOR SERVICES RENDERED INSIDE THE CITY OF

FOR QUARTER ENDING

FRANKFORT AND OUTSIDE FRANKLIN COUNTY)

CREDIT BALANCE

4. EARNINGS SUBJECT TO LICENSE FEE

( LINE 2 MINUS LINE 3)

DUE ON OR BEFORE

9. TOTAL DUE

5. LICENSE FEE DUE FOR QUARTER AT 1%

10. TOTAL PAYMENT DUE WITH THIS RETURN

ACCOUNT

No employees this quarter.

No employees in the future.

I HEREBY CERTIFY THAT THE INFORMATION AND

STATEMENTS CONTAINED HEREIN AND ANY

SCHEDULES OR EXHIBITS ATTACHED ARE CORRECT

DATE

OFFICIAL

TITLE

Owner, Partner, Manager, President, Etc.

SIGNED

State on this return if there has been any changes in name, ownership,

CUSTOMER COPY

PRINT NAME

address, etc. If a "FINAL RETURN" explain on reverse side.

INSTRUCTIONS for PREPARING and FILING FC-Form Q2

Each employer of one or more persons must withhold the license fee 1% from gross salaries, and commisions paid. All employees are subject to the license fee, except domestics

in the home and ordained ministers of religion, including employees of organizations in a business that is not subject to the license fee.

QUARTERLY RETURN -

A quarterly return for all license fees withheld must be filed and the license fee paid by the last day of the month following the close of the

calendar quarter. An employer shall be liable to a fine and imprisonment as provided by ordinance for failure to file a return. Interest and penalties are also provided for late

filing.

Line 1. Enter number of employees after eliminating those who are not subject.

Line 2. Enter total salaries, wages, commissions, incentive payments, bonuses and other compensation paid all employees during the quarter for which return is prepared.

If no salaries, wages, or other compensations was paid during this quarter, so indicate and file FC-Form Q-2 with explanation.

Line 3. Enter that portion of the compensation paid employees for services rendered inside the City of Frankfort and outside Franklin County.

Line 4. Represents the difference between Items 2 and 3.

Line 5. Shall be the actual license fee due at the rate of 1%.