Form Eq-1 - Employer'S Quarterly Return Of License Fee Withheld

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EMPLOYER’S QUARTERLY RETURN OF LICENSE FEE WITHHELD
FORM EQ-1
CITY OF RICHMOND, KENTUCKY
INSTRUCTIONS ON REVERSE
Under ordinance A-593
LICENSE FEE DIVISION
SIDE OF EMPLOYER’S COPY
QUARTER ENDING
I hereby certify that the information and statements
1. NUMBER OF TAXABLE EMPLOYEES
MO
DAY
YR.
contained herein and any schedules or exhibits attached
are true and correct.
2. TOTAL SALARIES, WAGES, COMMISSION AND OTHER
COMPENSATION PAID ALL EMPLOYEES ( * ) . . . . . . . . . . . . . . . . . . . . $
(SIGNED)
_____________________________________
3.
LESS NON-TAXABLE ITEMS (COMPENSATION PAID FOR
DUE ON OR BEFORE 30 DAYS AFTER CLOSE OF QUARTER.
SERVICES OUTSIDE CITY OF RICHMOND) . . . . . . . . . . . . . . . . . . . . .
(OFFICIAL TITLE)
_______________________________
Make Check or Money Order Payable To:
Owner, Partner, Member, President, Treasurer, Agent. DATE
4. TAXABLE EARNINGS (ITEM 2 MINUS ITEM 3) . . . . . . . . . . . . . . . . . . .
CITY OF RICHMOND
Mail To:
2% (.02)
5. ACTUAL TAX DUE IN QUARTER AT
. . . . . . . . . . . . . . . . $
CITY OF RICHMOND
BOX 1268, RICHMOND, KY 40476-1268
6. ADJUSTMENTS FOR PRECEDING QUARTERS . . . . . . . . . . . . . . . . . .
(859) 623-1000 EXT. 300
7. TOTAL AFTER ADJUSTMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8. PENALTY AND INTEREST (1% PER MONTH) . . . . . . . . . . . . . . . . . . . .
9. TOTAL (INCLUDES PENALTY AND INTEREST IF DUE) . . . . . . . . . . . . $
* If no wages were paid this quarter, mark “NONE” and return this
form with explanation.
PLEASE RETURN THE YELLOW COPY AND RETAIN THE PINK DUPLICATE
PLEASE NOTIFY THIS OFFICE OF ANY CHANGE IN OWNERSHIP OR NAME AND ADDRESS
SHOWN ABOVE.
IF RECEIPT IS DESIRED, RETURN EMPLOYER’S COPY OF THIS FORM AND ENCLOSE SELF-
ADDRESSED, STAMPED ENVELOPE.
Official form is smaller than full page. Please cut to size along dashed line before filing.
This form must be duplexed to avoid rejection.

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