Form 725 - Kentucky Single Member Llc Individually Owned Llet Return

Form 725 (2011)

Page 2

*1100020271*

Commonwealth of Kentucky

DEPARTMENT OF REVENUE

Q—S

CHEDULE

INGLE

EMBER

IMITED

IABILITY

OMPANY

UESTIONNAIRE

6. Was the limited liability company a partner in a pass-through

IMPORTANT: Questions 1—9 must be completed by the limited

liability company.

entity doing business in Kentucky for the tax year being



reported?

Yes

1. Single member’s (owner) name, address and Social Security

If yes, list name and federal I.D. of the pass-through

number or federal I.D. number _________________________

entity(ies).

______________________________________________________

2. List the following Kentucky account numbers. Enter N/A

Was the limited liability company doing business in Kentucky

for any number not applicable.

other than through its interest held in a pass-through entity

Employer Withholding ________________________________



doing business in Kentucky?

Yes

Sales and Use Tax Permit ______________________________



7. Was this return prepared on: (a)

cash basis, (b)

accrual

Consumer Use Tax ____________________________________



basis, (c)

other

_____________________________________

Unemployment Insurance _____________________________

8. Did the limited liability company file a Kentucky tangible

Coal Severance and/or

personal property tax return for January 1, 2012?

Processing Tax _______________________________________



Yes

3. If a foreign limited liability company, enter the date qualified

__ __

/ __ __ / __

to do business in Kentucky.

9. Is the single member limited liability company currently under

4. The limited liability company’s books are in care of: (name



audit by the Internal Revenue Service?

Yes

and address)

______________________________________________________

If yes, enter years under audit

______________________________________________________

If the Internal Revenue Service has made final and

5. Are disregarded entities included in this return?

unappealable adjus tment s to the limited liabilit y



Yes

company’s taxable income which have not been reported



to this department, check here

and file Form 740X for tax

If yes, list name, address and federal I.D. number of the

years 2005 through 2011 or Form 740-XP for 2004 and prior

entity(ies).

tax years, whichever is applicable, and file an amended

______________________________________________________

Form 725 for each year adjusted. Attach a copy of the final

______________________________________________________

determination to each amended return.

______________________________________________________

I, the undersigned, declare under the penalties of perjury, that I have examined this return, including all accompanying schedules and statements,

and to the best of my knowledge and belief, it is true, correct and complete.

✍

Signature of member (owner)

SSN or FEIN

Date

Name of person or firm preparing return

SSN, PTIN or FEIN

Date

May the DOR discuss this return with the preparer?



Yes

Email Address:

Telephone No.:

Form 725 - Kentucky Single Member Llc Individually Owned Llet Return - 2011 Page 2

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