Individual Return Of Occupation License Fee Return Form - City Of Auburn
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1Individual Return of Occupation License Fee Return
UNDER ORDINANCE 416, AS AMENDED BY ORDINANCE 1676
Customer Number:
Filed for Quarter Ending:
Business Name:
Due Date:
Addresss:
Delinquent Date:
Includes the Months Of:
1st Qtr: Due Date - April 1st
Delinquent After - April 30th
3rd Qtr: Due Date - October 1st
Delinquent After - October 31st
2nd Qtr: Due Date - July 1st
4th Qtr: Due Date - January 1st
Delinquent After - July 31st
Delinquent After - January 31st
Gross Salaries/Wages: Total compensation before any deductions i.e. federal/state taxes, retirement, benefits. Includes vacation/sick
1
leave pay, bonuses, and tangible personal property received as pay.
(Column A total from below)
2
Less: Salary/Wages reported to another municipality (city) and/or earned outside the city limits of Auburn (Column D total from
below)
3 Adjusted Gross Salaries/Wages: Line 1 minus Line 2 (Column C total from below)
4 License Fee: Line 3 multiplied by one-percent (1%)
5
Penalty: Line 4 multiplied by 10% (If filed 60 days after due date, penalty is greater of 10% of Line 4 or $50)
6 Interest: Line 4 multiplied by 1/2 of 1% (.005) for each month delinquent
7 Total Amount Due: Line 4 + Line 5 + Line 6 (See reverse side for payment options)
SCHEDULE OF COMPENSATION
Enter the gross salaries/wages which includes commissions, tips, bonuses, vacation/sick leave pay, fair market value of tangible personal property from
which the Auburn occupational license fee has not been deducted and reported to City by the employer(s).
Attach additional sheet if necessary
Compensation Columns
A
B
C
D
Compensation
Compensation
Gross
% of Time
Earned Inside
Earned Outside
Compensation
Worked in
Auburn
of Auburn
Employer's Name/Address
Received
Auburn
(Col. A x Col. B)
(Col. A - Col. C)
Show totals at top of form
DECLARATION: Under the penalties of perjury, I declare that this return is true, correct, and complete as required by
Ordinance No. 416 and Amended Ordinance No. 1676.
Payee Signature/Date: _________________________________________________________________________
INSTRUCTIONS FOR PREPARING AND FILING THIS FORM
This return must be filed by each individual whose earnings within the City of Auburn are from salaries, wages, commissions, and/or other
compensations, received from one or more employers, on which the City of Auburn Occupation License Fee was NOT deducted by
employers.
Show information concerning your employment in the chart above.
Gross earnings is the total amount before any deductions,
such as federal/state taxes, retirement, and any other benefits.
Gross earnings
include salaries, wages, commissions, tips, bonuses, incentive
payments and other compensation, whether received directly or through an agent and whether paid in cash or in kind.
Boarding, lodging and
similar items furnished must be included as earnings at their fair market value.
Return must be filed for each quarter (three-month period) of
the year.
Payment Options: Cash, Check, Money Order, Credit Card (Visa/MasterCard ONLY)
Card # ___ ___ ___ ___ - ___ ___ ___ ___ - ___ ___ ___ ___ - ___ ___ ___ ___
Expiration Date: ____/____
Mail To: Revenue Office - 144 Tichenor Avenue - Suite 6 - Auburn, Alabama 36830
Office: (334) 501-7239 - Fax: (334) 501-7297 - Website:
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