Form Rd-103 - Business License Application Flat Rate
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1City of Kansas City, Missouri - Revenue Division
RD-103
BUSINESS LICENSE APPLICATION
(12/15)
Flat Rate
Phone:
(816) 513-1120
E-file:
kcmo.gov/quicktax
Legal Name:
Mailing Address:
DBA Name:
FEIN / SSN:
Business Address:
Account ID:
Period From:
Period To:
NAICS CODE:_______________________
1. Section A - Flat Fee Filer
a)Table Number Used (from instructions)
1a
DOLLARS
CENTS
.
b)Select flat fee rate from table and place on Line 1B
1b
$
2. Section B -Filers Using "Units" Calculation
a)Table Number Used (from Instructions)
2a
b)Number of Units for full year or Units from Table, if applicable
2b
.
c)Select Rate From Table (Multiply Line 2b by Dollar Rate Per Unit)
2c
$
3. Fee Due (Enter Calculated Fee From Sections A - Line 1b or Sections B - Line 2c
.
3
above)
$
4. Penalty: "Failure to file return timely" (5% per month of the outstanding tax due
.
Maximum penalty 25%)
4
$
.
5. Penalty: "Failure to pay amount due" (5% of tax due)
5
$
6. Interest (3% per annum until tax is paid)
6
$
.
7. Total Annual Fee Due (Sum Lines 3,4,5 and Line 6)
7
$
.
8. Amount Paid
8
$
.
9. If business closed prior to January 1, ENTER DATE BUSINESS CLOSED
9
/
/
MM
DD
YY
10. "X" box if amended (Section A or Section B must be completed)
10
Notes:
Business License expires December 31 of each year. To avoid penalty file and pay before March 1st
Gross receipts from previous tax year:
$______________________________________________
DO NOT SEND CASH. Make check payable to: KCMO City Treasurer
Mail to: City of Kansas City, Missouri, Revenue Division, PO Box 804103 Kansas City, MO 64180-4103
I authorize the Commissioner of Revenue or delegate to discuss my return and attachments with my preparer.
Yes
No
Under penalties of perjury, I declare this return to be true, correct, and complete accounting for the taxable year stated.
Date
Phone
Print Name of Taxpayer
Signature
Title
Date
Phone
Preparer Name (if other than taxpayer)
Signature
Title
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Parent category: Financial