Net Profits License Fee Return Form - City Of Springfield printable pdf download

TO VIE W O R D I NA N CE

GO TO

www. sp ri n gf ield ky. org

(office use only)

CASE

I CHECK

( P R I N T N A M E A N D A D D R E S S B E L O W - C H A N G E l F N O T C O R R E C T L Y S H O W N )

F e d e r a l T a x l D N o .

Give Trade Name, lf Any

Social Security Number:

Page 1

Remit to:

crry oF spRtNGFtELD

- L|OENSE

FEE DTVTSTONO 20 _

127 WEST MA|N ST. . SPR|NGF|ELD, KY 40069 . PHONE (859) 336-5440

NET PROFITS LICENSE FEE RETURN

Under Ordinance 2007-01 0

F R O M B U S I N E S S , P R O F E S S I O N , O R O T H E R A C T I V I T Y W I T H I N T H E

C I T Y O F S P R I N G F I E L D , C O N D U C T E D B Y C O R P O R A T I O N S ,

P A R T N E R S H I P S ,

I N D I V I D U A L S A N D F I D U C I A R I E S O F E S T A T E S A N D

TRUSTS.

( R E S T D E N T O R N O N - R E S | D E N T )

C A L E N D A R Y E A R E N D E D D E C E M B E R 3 1 , 2 0 -

O R

AYROLL

Mo.

Dav

Year

E P A R T M E N T

F I S C A L Y E A R E N D I N G :

C O M P U T A T I O N O F L I C E N S E F E E

Net Profits Subject to License Fee (Enter Line 7, Schedule A, Page 2.)

Springfield License Fee @ 1%

lnterest 1"/" Per Month

Check Which: DCorporation;

E Fiauciary, I Other (State)

EPartnership, D

Date Business Started or Trust Created

Did you pay a business privilege License for Previous Year?

(Yes or

lf organization was Discontinued, state whether by Dissolution

5 .

Failure to file or late filing of return: subject to a civil penalty equal to six percent (60lo) per annum in addition to a

charged penalty of one half of one percent of the amount of the unpaid license fee for each thirty (30) days or fraction

thereof elapsing between the due date of lhe return and the date on which filed.

Total (ltems 2,3, and 4)

Balance Due . .

o uEsloNs (ANSWER FU LLY)

No)

lf answer

Explain:

Has Return of Information for Each Employee, as Per the Regulations

Been Forwarded to the License Fee Div.?

(Yes or No)

Check Whether this Retum is Prepared on

Has Springfield License Fee been withheld from All Subject

Employees and Remitted Quarterly in accordance with Regulations

Y e s D N o D

to springfield License Fee and check if not included in this retum.

I Not Included

or Sale

Cash

or Accrual

Basis.

lf by sale, Give Name and Address of Successor Organization'

Show Name and Address of each place of Business operated Subjec't

Did you have any Employees in Springfield in taxable year?

Y e s D N o D

Prepared By

C E R T I F I C A T E

I HEREBy CERTIFy That the slarements made herein and in any supporting schedule or exhigit are true, conect and complete.

, 2 0 -

(Signature of License Fee Payer)

Date

This relum must be liled with fufl paymenr of the tee on or betore April

'15, aller close of calendat year, or within I 05 days from the clos€ of }!ur tiscaly!at' wlth thc clt

ot Springlield, Kentucky 40069. Make all checks pafable to Collectof, Clty of Springfield' Ky'

Net Profits License Fee Return Form - City Of Springfield

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