Kc Form 1 - Business License Fees - Kenton County Fiscal Court
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KC FORM 1 REV. 12/12
IMPORTANT: * A ZONING PERMIT MAY BE REQUIRED BEFORE YOU BEGIN BUSINESS ACTIVITY. CONTACT
QUESTIONS OR ASSISTANCE
CITY OR COUNTY AS NEEDED AT TELEPHONE NUMBER ON BACK FOR DETERMINATION.
PLEASE CALL
Office of License Inspector
* DOOR-TO-DOOR SOLICITATION REQUIRES ADDITIONAL CITY PERMIT. CONTACT CITY
(859) 392-1440 ∙ Fax (859) 392-1459
OR COUNTY AS NEEDED AT TELEPHONE NUMBER ON BACK FOR DETERMINATION.
BUSINESS LICENSE FEES
(Fees do not apply to non-profit organizations, clergy, or domestic servants.)
1)
CHECK ONE:
NEW APPLICATION
ADDING A CITY LICENSE TO EXISTING LICENSE#
2)
CHECK BELOW AS NEEDED: (A) CITY LICENSE(S) ONLY OR: (B) COUNTYWIDE BUSINESS LICENSE
Kenton County Fiscal Court
A) CITY LICENSE(S) ONLY:
Kenton County Building, Room 311
CITY
FEE
CITY
FEE
CITY
FEE
CITY
FEE
303 Court St. P.O. Box 792
Covington KY 41012-0792
BROMLEY
$50
ELSMERE
$50
INDEPENDENCE
$50
TAYLOR MILL
$50
COVINGTON
$50
ERLANGER
$50
LAKESIDE PARK
$50
The Collecting Agent for Occupational
VILLA HILLS
$50
License Fees for Kenton County and
LUDLOW
$100
CRESCENT SPRINGS $50
FORT MITCHELL
$50
Cities', Kentucky
NO
CRESTVIEW HILLS $50
PARK HILLS
$50
KENTON COUNTY
FORT WRIGHT
$50
FEE
OFFICE USE ONLY
EDGEWOOD
* $100
CITY ______________________
$225.00
ZONING APPROVAL________
B) COUNTYWIDE BUSINESS LICENSE Valid in all Cities above.
TOTAL "A" OR "B"
DATE______________________
*EDGEWOOD: $50 of Edgewood fee can be applied as credit to annual Edgewood net profit tax.
FORMS TO SEND____________
MAKE CHECK PAYABLE T KENTON COUNTY FISCAL COURT
WARNING:
SET D ____________________
Statements in this application shall be made under oath, or by affirmation or by any other legally authorized manner of attesting to
ANN YR _______ LIC YR____
the truth of such statement. Any false statements made herein shall be punishable according to law; and may be cause for denial
LIC. EXP DATE______________
of the application or the revocation of the business license issued pursuant thereto.
ACT CODE _________________
PLEASE TYPE OR PRINT:
PIDN_______________________
SUBS_______________________
1) Complete Name of Business Owner
SIC CODE___________________
2) Address
OCC LIC NUMBER
_____________________
City, State and Zip + 4
3) Telephone (
)
Fax (
)
Emergency or Night No. (
)
4) Trade Name of Business
5) Street address of where business will be conducted in Kenton County
6) Telephone (
)
Fax (
)
Emergency or Night No. (
)
7) Mailing Address for Tax Forms
City, State and Zip + 4
8) Contact Persons: For Payroll Withholding, Annual License Fees, Business License Renewal Fee
)
Email
Title
Telephone (
Name
9) CHECK ONE ONLY AND COMPLETE:
11) List All Hazardous Materials, Pets or Guard Animals, Used or Located on
-
-
SOLE PROPRIETOR:
Property.
Soc. Sec No.
Date of Birth
Month
Day
Year
12) Will any part of business activity be performed from your home?
CORPORATION___:
Date organized
State
No
Yes
13) Date Business to Begin in County
Accounting Period:
Calendar Year
Fiscal Year Ending
Month
Year
Month
Day
14) Do You or Will You Have Employees?
Process Agent Name
Est. No. of Employees
Yes
No
Address
15) Do You or Will You Use Independent Contractors?
City State Zip
Yes (Include names & addresses)
No
Officers' Names
16) Do You or Will You Use "Leased" or "Temporary Help" employees?
and Addresses
Est. No. of Employees
No
Yes
If yes, include name(s) and address(es) of leasing or temporary agency(s).
PARTNERSHIP:
Partners' Names
and Addresses
17) Nature of Business
(Please describe your business and its operation, including
NON-PROFIT (Attach IRS Determination of Status)
where and how sales, services or other activities take place. If nature of business is own or
operate rental property, include full address of rental property.)
OTHER:
Please Describe
-
10) Federal Tax Identification Number:
Business Activity Code:
I HEREBY CERTIFY THAT ALL INFORMATION AND STATEMENTS HEREIN ARE TRUE AND CORRECT. (Application and payment will be returned if any
part incomplete.) Occupational License will be issued upon processing of completed application.
X
(SIGNATURE)
(DATE)
(PRINT NAME)
(TITLE)
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