Form W-1 D - Monthly Withholding Deposit Form
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1LOUISVILLE/JEFFERSON COUNTY
FORM
1
METRO REVENUE COMMISSION
W-
D
MONTHLY WITHHOLDING DEPOSIT FORM
CHECK IF CHANGED
Name
_________________________________________________________________________________
Address
_________________________________________________________________________________
City
_________________________________
State ___________
Zip _______________
SSN
_________________________________
Phone
Ext
_____________________
_________________
__________________________________________________________
____________________
PREPARER/CONTACT PERSON
TITLE
ACCOUNT NO
QUARTER ENDING
PHONE NUMBER
FEDERAL ID NO.
DEPOSIT AMOUNT
$
CHECK APPLICABLE MONTH DEPOSIT IS FOR
January
April
July
October
Due Date: February 15th
Due Date: August 15th
Due Date: May 15th
Due Date: November 15th
February
May
August
November
Due Date: March 15th
Due Date: June 15th
Due Date: September 15th
Due Date: December 15th
March
June
September
December
Due Date: April 15th
Due Date: July 15th
Due Date: October 15th
Due Date: January 15th
INSTRUCTIONS
•
If any of the above account information is incorrect, please correct where indicated.
•
Enter the name and phone number of the preparer or the person to be contacted, if additional information is required.
•
Enter the quarter for which the deposit is being made, if necessary.
•
Enter the amount of tax which was required to be withheld during the month covered by this deposit.
•
Check the applicable month for which the deposit is being made.
REQUIREMENT FOR PAYMENT OF TAX:
Every employer who is responsible for withholding occupational license fees of more than $3,000.00
during any one of the four (4) preceding quarters must submit monthly deposits of the occupational license fees withheld to the Louisville/Jefferson
*
County Metro Revenue Commission. All monthly withholding tax deposits are due fifteen (15) days after the month end.
All employers will be required to file a quarterly withholding tax return (FORM W-1) by the last day of the month following the close of the calendar
quarter.
License Fee Return For
Filed by
(* Postmarked or Hand Delivered)
st
1
quarter
April 30
nd
2
quarter
July 31
rd
3
quarter
October 31
th
4
quarter
January 31
MAILING ADDRESS: P.O. BOX 37740 • LOUISVILLE, KENTUCKY 40233-7740
Telephone: (502) 574-4860 •
• Fax: (502) 574-4818 • • TDD: (502) 574-4811
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