Application For Occupational License - City Of Glasgow - State Of Kentucky
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1City of Glasgow, Kentucky
Phone: (270) 651-5131
Application for Occupational License
Fax:
(270) 651-2511
P. O. Box 278
Glasgow, KY 42142-0278
Assigned Acct #:
Business Name:
Local Site Phone#:
(dba name)
Local Site Fax #:
Local Address:
Description of
Business:
Start Date in Glasgow:
Will you have employees working in Glasgow?
( ) No
( ) Yes
Approx. # of Employees
**Note that contract labor must be licensed individually**
Check Entity Type:
( ) Proprietorship ( ) Partnership ( ) Corp ( ) LLC ( ) LLP
( ) Non-Profit ( ) Other
Quarterly Withholding Tax Return Mailing Address
(if different from above)
Phone:
Fax:
Contact:
Net Profit License Fee Return Mailing Address
(if different from above)
Phone:
Fax:
Contact:
**I am aware of the following Occupational Licensing requirements:**
1.5% Occupational tax on Gross Payrolls which I am obligated, as employer, to withhold and remit to the City of Glasgow on
a quarterly basis.
A Net Profit Return must be filed annually, based on 1.5% of the business profits. I understand that this return must be
completed regardless of profit earned.
***
SIGNATURE OF APPLICANT
DATE
INFORMATION BELOW IS NOT AVAILABLE TO PUBLIC
Accounting Period Per Federal Return:
Calendar Year
Fiscal Year End Date
Federal I.D. Number:
Social Security Number:
(If applicable)
Federal Id # or Social Security # is Required
OWNER INFORMATION
:
(if corp, list officers of corp)
Name:
Name:
Address:
Address:
SS#:
Phone:
SS#:
Phone:
Date of Birth:
Date of Birth:
ATTACH SEPARATE SHEET IF NECESSARY
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