Form Molt-1a - Marshall County Occupational License Tax For Schools - 2012

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MARSHALL COUNTY OCCUPATIONAL LICENSE TAX FOR SCHOOLS 
Withholding Tax Reconciliation for year 2012 
2012
86 High School Road, Benton, KY  42025 
DUE ON OR BEFORE FEBRUARY 28, 2013 
Form MOLT‐1A   
 
 
 
 
 
 
 
 
W/H Acct. ID No. _______ 
Instructions to Employers:  List below the name (alphabetically), address, and Social Security Number of all persons employed by you in Marshall 
County during the 2012 calendar year.  Show the total amount of wages, salaries, commissions and other compensations paid each employee during 
this period, and the amount of MARSHALL COUNTY OCCUPATIONAL LICENSE TAX FOR SCHOOLS withheld from all taxable employees.  NOTE – Tips and 
gratuities reported to employers for social security or federal income tax purposes, bonuses, and “tax sheltered annuity” plans for employees of public 
schools, etc., all constitute taxable income to be included in taxable payroll.  If additional space is needed for listings, use reverse side of this form or a 
plain sheet of paper. Enter column totals and furnish summary of quarterly forms as requested.   Copies of W‐2 forms or other type of alphabetical 
listing are acceptable in lieu of the listing form below; however, totals should be entered on Line 3.   
Col. 1 
Col. 2
 
 
 
       Occupational Tax for 
    Social Security # 
Name and Address of Employee 
     Total Earnings 2012 
          Schools Withheld 
 
 
 
 
1. Total columns at right 
 
 
                                           
2. Enter total from Page 2 and any additional pages                                                                                                                  
3. TOTAL OF LINES 1 AND 2                                                                                                                                                             
Summary of tax withheld and paid as reported on Form MOLT‐1 for quarters ended: 
March 31 $____________; June 30 $____________; Sept. 30 $____________; Dec. 31 $____________ =  
 TOTAL  $__________________ 
Please attach explanation if difference from total of Column 2 is more than minimal due to fractional variations. 
Business Name ___________________________________________________________________________________________________ 
Business Address _______________________________________________________________________Phone_____________________ 
Signature ______________________________________________  Title ___________________________  Date ____________________ 

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