Form Ol-3ez - Occupational License Return
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1OCCUPATIONAL LICENSE RETURN OL-3EZ
City of Louisville; Jefferson County, Kentucky;
Mass Transit; School Boards
PO Box 35410
Louisville KY 40232-5410
Phone :(502)574-4860
FAX: (502)574-4818
DUE 15TH DAY OF THE 4TH MONTH FOLLOWING THE CLOSE OF THE FISCAL YEAR
FOR YEAR ENDED
If name change only check box
MONTH
DAY
YEAR
Print
ACCOUNT NUMBER
Name &
Address
NO ACTIVITY
FINAL RETURN (Check only to close account.) Date Operations
Place check mark in box if there was no activity
.
Ceased:______________________________________
Income or (Loss)
1)
1) Amount of contract labor per Form 1099-Misc or gross wages per Form W-2
(Attach a copy of Form 1099-Misc, Form W-2, or page 1 of Form 1040)
1) $______________
Tax Computation
Do you live in Jefferson County? If yes, complete Section A only. If no, complete section B.
Section A
(Residents of Jefferson County)
2) Amount of income per Line 1 earned in Louisville *
2) $____________
3) Amount of income per Line 1 earned in Jefferson County *
outside Louisville
3) $____________
4) Total Louisville and Jefferson County income (Line 2 + Line 3)
4) $____________
0.00
5) Tax Due (Multiply Line 4, Section A by 2.2%)
5) $____________
6) Penalty and Interest **
6) $____________
7) Amount to be paid (Line 5 + Line 6)
7) $____________
0.00
Section B
(Non-residents of Jefferson County)
2) Amount of income per Line 1 earned in Louisville *
2) $____________
3) Amount of income per Line 1 earned in Jefferson County *
outside Louisville
3) $____________
4) Total Louisville and Jefferson County income (Line 2 + Line 3)
4) $____________
0.00
5) Tax Due (Multiply Line 4, Section B by 1.45%)
5) $____________
6) Penalty and Interest **
6) $____________
7) Amount to be paid (Line 5 + Line 6)
7) $____________
0.00
.
I hereby certify, under penalty of perjury, that the information herein and in any supporting schedules are true, correct and complete to the best of my knowledge
Signature of Tax Return Preparer
Your Signature
Date
Your Social Security #
Mail Form OL-3EZ, along with a copy of the federal Schedule C, and check or money order with account number
Who may file Form OL-3EZ?
This return may be used only if
* Amounts on lines 2 and 3 must be determined based upon guidelines contained in
a)
you are an individual (not a corporation or a
Section 3.14 of the Regulations of the Louisville/Jefferson County Metro Revenue
partnership) and
Commission
b)
you had no business expenses for the year ended
reported above and
**If this return was filed after the due date, you will be billed for the penalty and
c)
you are not a domestic servant or a minister.
interest due.
Penalty - Failure to pay by due date……5% of tax due
Failure to file by due date…….5% of tax due, per month up to 25%
Interest - 12% per annum of tax due
(Rev. 4/1/2003)
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