Form 740np-Wh - Kentucky Nonresident Income Tax Withholding On Distributive Share Income Transmittal Report And Composite Income Tax Return
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1*1000020292*
740NP-WH
For Taxable
Year Ended
40A201 (10-10)
__ __ / __ __ / __ __
Check if
Composite Income Tax Return
KENTUCKY NONRESIDENT INCOME TAX WITHHOLDING ON
Amended Return
DISTRIBUTIVE SHARE INCOME TRANSMITTAL REPORT
Estimated Payment
AND COMPOSITE INCOME TAX RETURN
Extension Payment
(To be completed by Pass-through Entities Only)
Change of address
(1) FEIN
(2) Kentucky Corporation/LLET Account Number
(3) Name of Pass-through Entity
Street Address
City
State
ZIP Code
(4) Number of nonresident individuals, estates, trusts and C corporations subject to withholding
4
(5) Number of nonresident individuals, estates, and trusts subject to income tax (composite return only)
5
(6) Kentucky distributive share income before apportionment (see instructions)
6
00
(7) 100% or the apportionment factor from Schedule A, Section I,
%
line 12
7
(8) Kentucky distributive share income subject to withholding/income tax
(line 6 multiplied by line 7)
8
00
(9) Tax before credit (line 8 multiplied by .06 (6%))
9
00
(10) Enter pass-through partners’, members’ or shareholders’ non-
refundable credits (attach schedule)
10
00
(11) Kentucky income tax due (line 9 less line 10)
11
00
(12) Amount paid (see instructions)
12
00
(13) Balance of tax due. If line 11 is greater than line 12, enter line 11 less line 12.
13
00
(14) Tax overpayment. If line 11 is less than line 12, enter line 12 less line 11.
14
00
(15) Amount credited to 2011
15
00
(16) Amount to be refunded (line 14 less line 15)
16
00
TAX PAYMENT SUMMARY
(Round to nearest dollar)
Make check(s) or money order(s)
payable to Kentucky State Treasurer.
Tax (Line (13))
1.
$_____________________________
Mail to:
2.
Penalty
$_____________________________
Kentucky Department of Revenue
Interest
3.
$_____________________________
Frankfort, KY 40619-0006.
Total Payment
4.
$_____________________________
I declare under the penalties of perjury that this return, including all accompanying schedules and statements, has been examined
by me and, to the best of my knowledge and belief, it is true, correct and complete.
Print name of partner, member or shareholder
Signature of partner, member or shareholder
Daytime telephone number
Date
Name of person or fi rm preparing return
Date
May the DOR discuss this return with the preparer?
Yes
No
E-mail Address:
SSN, PTIN or FEIN
Telephone No.:
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