Form 001-Fy - Annual Occupational Tax Return - Johnson County, Kentucky
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1FISCAL YEAR
Johnson County Form
Johnson County Annual Occupational Tax Return
001-FY
Johnson County Occupational Tax Rate: 0.50%
Tax Administrator: Eda Bussey
POSTMARK DUE DATE:
Out of business, check here
Date closed:
Current Contact Information
Please Make Corrections In The Box To The Right
Contact Information Corrections
Account Number
Active Date
Account Number
Active Date
Account Name
Account Name
Address
Address
City / State / Zip
City / State / Zip
Phone
Phone
OCCUPATIONAL TAX WORKSHEET
Please Enter All Requested Information
$
01. Total net income as shown on attached Schedule C of state or fed. return..........................................................
%
02. Percentage of time working in Johnson County....................................................................................................
$
03. NET income subject to Johnson County Occupational Tax (Line 1 x Line 2).......................................................
$
04. Johnson County Occupational Tax due (Line 3 x 0.50%)....................................................................................
BUSINESSES ONLY complete lines 05 and 06. All others skip lines 05 and 06
$
05. Deduct $25.00 for license fee IF previously paid this year....................................................................................
OR
$
06. Add $25.00 for license fee if NOT previously paid this year..................................................................................
IF PAID ON OR BEFORE________GO TO LINE 09. OTHERWISE COMPLETE LINES 07, 08 AND 09
$
07.
LATE FEE - Add 8.00% Interest (of line 4) per year due.......................................................................................
$
08.
PENALTY - Add $100.00 or 10.00% --whichever is greater--(of line 4)................................................................
$
09. PAY THIS AMOUNT (Total of lines 4 through 8)...............................................................................................
Direct all questions or comments to:
Eda Bussey Occupational Tax Administrator.
(606) 789-2550
Please sign below
I hereby certify that the statements made herein and in any supporting schedules attached are true, correct and complete to the best of my
knowledge.
Signature of Form Preparer
Date
Signature of Taxpayer
Date
Return and make check payable to: Johnson County Fiscal Court PO Box 868 Paintsville, KY 41240
Detach and Keep This Stub For Your Records
Account Number
Active Date
Fiscal Year
Date Paid
Account Name
Amount Paid
Check Number
Address
City / State / Zip
Authorized By
Phone
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Parent category: Financial