__ __ __ __ __ __
725
A
*1100020270*
Kentucky Corporation/LLET Account Number
41A725
K
S
M
LLC
ENTUCKY
INGLE
EMBER
2011
Department of Revenue
I
O
NDIVIDUALLY
WNED
➤ See instructions.
LLET R
Taxable period beginning ______________ , 201 ___, and ending ______________ , 201 __ .
ETURN
__ __ – __ __ __ __ __ __ __
C
Federal Identification Number
__ __ / __ __
B
Check applicable box(es):
Taxable Year Ending
__ __ __ – __ __ – __ __ __ __
Mo.
Yr.
Social Security Number
LLET
State and Date of Organization
Name of LLC
Receipts Method
Principal Business Activity in KY
Gross Receipts
Name of Owner
Gross Profits
$175 minimum
NAICS Code Number
Number and Street
(Relating to Kentucky Activity)
(See )
City
State
ZIP Code
Telephone Number
Nonfiling Status Code
D
Check if applicable:
Qualified investment pass-through entity
I nitial return
Final return (attach explanation)
Amended return
Enter Code
Short-period return (attach explanation)
Change of name
Change of address
Change of accounting period
E
Check applicable box:
Composite return
Single return
______ ______
PART I—KENTUCKY NET DISTRIBUTABLE INCOME
PART II—LLET COMPUTATION
1. Ordinary income (loss) ..................
1
00
1. Schedule LLET, Section D, line 1 ...
1
00
2. Net income (loss) from rental real
2. Recycling/composting equipment
estate activities ...............................
2
00
tax credit recapture ........................
2
00
3. Net income (loss) from other
3. Total (add lines 1 and 2) ................
3
00
rental activities ...............................
3
00
4. Nonrefundable LLET credit from
4. Interest income ..............................
4
00
Kentucky Schedule(s) K-1 ..............
4
00
5. Dividend income ............................
5
5. Nonrefundable tax credits
00
5
00
6. Royalty income ..............................
00
(Schedule TCS) ...............................
6
7. Net short-term and long-term
6. LLET liability (greater of line 3 less
6
00
capital gain (loss). If net (loss),
lines 4 and 5 or $175 minimum) .....
00
7
do not include more than
7. Estimated tax payments ................
7
00
8
00
($3,000) ...........................................
8. Certified rehabilitation tax credit ..
9
00
9. Film industry tax credit ..................
8. Section 1231 net gain (loss) ..........
8
00
9
10
00
9. Other income (attach schedule) ......
00
10. Extension payment ........................
10
00
11
00
10. Other deductions (attach schedule)
11. Prior year’s tax credit .....................
11. Total net distributable income
12. LLET due (line 6 less lines 7 through 11)
12
00
00
11
13. LLET overpayment (lines 7
(lines 1 through 9 less line 10) ......
13
12. Enter 100% or the apportionment
through 11 less line 6) ....................
00
14
fraction from Schedule A, Section
14. Credited to 2012 LLET ....................
%
12
15
00
I, line 12 (attach schedule) ..............
15. Amount to be refunded .................
PART III—LLET CREDIT FOR MEMBER
1. LLET liability (Part II, the total of
Federal Schedules C, E and F, and any other
➤
1
lines 4 and 6) ..................................
00
supporting federal forms and schedules must
2
2. Minimum tax ..................................
175
00
be attached.
3. Member’s LLET credit
3
(line 1 less line 2) ...........................
00
TAX PAYMENT SUMMARY
(Round to nearest dollar)
Make check payable to:
LLET
Kentucky State Treasurer
1. LLET due (Part II, line 12)
$_____________________________
Mail return with payment to:
2. Penalty
$_____________________________
Kentucky Department of Revenue
3. Interest
$_____________________________
Frankfort, Kentucky 40620
4. Total Payment
$_____________________________