Form W-1 - Employers Quarterly Return Of Occupational License Fees Withheld

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FORM W-1
EMPLOYERS QUARTERLY RETURN OF OCCUPATIONAL LICENSE FEES WITHHELD
CITY OF LOUISVILLE, JEFFERSON COUNTY, MASS TRANSIT AND SCHOOL BOARDS
COLLECTION AGENT LOUISVILLE/JEFFERSON COUNTY METRO REVENUE COMMISSION
101 S 8TH St. Louisville, KY 40202-2601
PHONE: 502/574-4862
FAX: 502/574-4818
FAX ON DEMAND: 502/574-4967
ATTENTION: THIS FORM HAS BEEN REVISED TO INCLUDE EMPLOYERS WHO PAY WITHHOLDINGS
QUARTERLY OR MONTHLY
REMIT TO: P.O. BOX 35410 • LOUISVILLE, KENTUCKY 40232-5410
FEDERAL ID #
PHONE #
NEW PHONE #
NEW FEDERAL ID #
DATE
PLEASE CHANGE ANY INFORMATION ABOVE WHICH IS INCORRECT
ACCOUNT #
OFFICE USE ONLY
I had no employees this quarter -----------------------------------------------
FOR QUARTER
I will have no employees in future -------------------------------------------
ENDED
DUE ON OR
EFFECTIVE DATE
INITIALS
BEFORE
THE ENTRIES ON LINES 1-5 SHOULD
QUARTERLY WAGES
TAX DUE
INCLUDE ONLY AMOUNTS EARNED
BY EMPLOYEES FOR WORK THAT
ENTER TOTAL PAYROLL OF CITY OF LOUISVILLE, KY
1.
WAS PERFORMED WITHIN
(x)1.45%=
(1)
LOUISVILLE AND JEFFERSON
COUNTY, KY. THE ENTRIES ON
2.
ENTER TOTAL PAYROLL OF JEFFERSON COUNTY, KY
LINES 1, 2, & 3 SHOULD NOT
(x)1.45%=
(2)
INCLUDE AMOUNTS EARNED
BY ORDAINED MINISTERS OR
3.
ENTER COMBINED LOUISVILLE AND JEFFERSON CO.
DOMESTIC SERVANTS.
PAYROLL (LINE 1 + 2)
LESS AMOUNT OF CITY & COUNTY PAYROLL EARNED
4.
BY NON-RESIDENT EMPLOYEES.
5.
TOTAL EARNED BY RESIDENT EMPLOYEES FOR
WORK PERFORMED WITHIN LOUISVILLE AND
(x).75%=
(5)
JEFFERSON CO., KY. (LINE 3 - 4) . INCLUDE AMOUNTS
EARNED BY MINISTERS AND DOMESTIC SERVANTS.
(6) TOTAL TAX DUE
IF LINE 6 IS OVER $3000.00 YOU MUST BEGIN MAKING MONTHLY
(1+2+5)
DEPOSITS BEGINNING NEXT QUARTER
MONTH
DUE
MONTH
DUE
MONTH
DUE
MONTH
DUE
ENDED
DATE
ENDED
DATE
ENDED
DATE
ENDED
DATE
January…………Feb. 15
April………..May 15
July……………Aug. 15
October ……..Nov. 15
February………..Mar. 15
May……….June 15
August ……..…Sep. 15
November…….Dec. 15
March……………Apr.15
June……….July 15
September…….Oct. 15
December……Jan. 15
(7)
INTEREST AND
PENALTY
RECONCILIATION
This section should be completed BY ONLY THOSE EMPLOYERS WHO ARE REQUIRED TO MAKE
(8)
TOTAL TAX DUE
(6 + 7)
MONTHLY DEPOSITS (APPLIES TO EMPLOYERS WHO PAID LICENSE FEES TOTALING more than
-
$3000.00 during any one of the preceding 4 calendar quarters).Figures on Lines 9A-9C must reflect the
amount that should have been paid for each month and should be equal to the Total Tax Due(Line 6)
(9)
A
B
C
(10)
TOTAL AMOUNT DUE
(TOTAL LINE 9)
(A+B+C)
ST
ND
RD
AMOUNT DUE 1
MONTH
AMOUNT DUE 2
MONTH
AMOUNT DUE 3
MONTH
(11)
TOTAL DEPOSIT FOR
FOR OFFICE USE ONLY
THIS IS TO CERTIFY THAT THE INFORMATION SHOWN ON THIS RETURN IS TRUE AND CORRECT
AMOUNT PAID_______________
(12) ADDITIONAL PAYMENT DUE
TO THE BEST OF MY KNOWLEDGE
(13) OVERPAYMENT-CREDIT
REQUESTED
(ATTACH EXPLANATION)
X
AUTHORIZED SIGNATURE
TITLE
Rev: 1/21/03

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