Form 102 - Net Profit And Shively Occupational Tax Report Form Page 2
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1
2Form ___________
Page 2
SCHEDULE 1
BUSINESS LOCATIONS IN SHIVELY
To be completed by all licensees, with more than one business location in Shively and Jefferson County, and by
licensees whose mailing addresses are not their local business addresses. List below all business locations
and indicate whether or not the profit from the operation at each location listed is included in this return. If
profit is not included, give account number under which operation is filed.
NAME
STREET ADDRESS
PROFIT INCLUDED
ACCT. NUMBER
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
SCHEDULE 2
CHANGE IN OWNERSHIP OR ACTIVITY
To be completed by each licensee who ceased doing business or whose business changed ownership during the past year.
A.
Date ceased doing business ______/______/______
B.
Date of change or ownership _____/_____/_____
C.
If the ownership changed, give the name and address of new owner: _______________________________________________________
_____________________________________________________________________________________________________________________
D.
Other pertinent information __________________________________________________________________________________________
_____________________________________________________________________________________________________________________
SCHEDULE 3
ADJUSTMENT OF FEDERAL TAX BASE TO OCCUPATIONAL LICENSE TAX BASE
(The alcoholic beverage net profits deduction is applicable to individuals, partnerships and corporations. An individual
licensee, however, should make no other entries in this Schedule except as to specific items (and amounts)
which are included in his Federal Schedule C and / or F for this same period.)
DEDUCTIONS ALLOWABLE ON FEDERAL
ITEMS SUBJECT TO FEDERAL TAX BUT
RETURN BUT NOT ON THIS RETURN
EXEMPT FROM OCCUPATIONAL TAX
A.
State or Local Taxes Based on Income $_______________
F.
Profit from Sale of Alcoholic
B.
Occupational License Fees...................
_______________
Beverages ........................................ $______________
C.
Partners’ Salaries (attach Schedule)....
_______________
G.
Interest on U.S. Gov’t Obligations...
______________
D.
Other Items (attach Statement).............
_______________
H.
Other Items (attach Statement)........
______________
E.
Total Additions........................................ $_______________
I.
Total Deductions................................ $______________
NET ADJUSTMENT (Line E minus Line I). Enter here and in Part II (Line 5, Section A, or Line 4, Section B)........................ $______________
SCHEDULE 4
COMPUTATION OF ALLOCATION PERCENTAGES
The allocation formula is to be used to determine the ratio of net profit or gain from any trade or profession derived from activity within and
outside the City of Shively.
Column A
Column B
Column C
Allocation Factors
Total
Shively
Percentage
1. GROSS RECEIPTS from sales made and / or services rendered.... $
$
%
2. (a) Total wages, salaries and other compensation of all
employees......................................................................................
(b) LESS: Compensation of executive officers if applicable...........
TOTAL NET WAGES FACTOR
$
$
%
3. TOTAL PERCENTAGES in Column C
%
4. AVERAGE PERCENTAGE (Line 3 divided by Total _____% 2)
%
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