Form W-1 Kjda - Quarterly Withholding Tax Return For Employers Claiming
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FORM W-
LOUISVILLE METRO REVENUE COMMISSION
.50
KJDA (
%)
QUARTERLY WITHHOLDING TAX RETURN FOR EMPLOYERS
CLAIMING THE KENTUCKY JOBS DEVELOPMENT AUTHORITY CREDIT
CHECK IF CHANGE IN ADDRESS IS BELOW
Name
__________________________________________________________________________________
Address
__________________________________________________________________________________
City
_________________________________
State __________
Zip _______________
Federal ID _________________________________
Phone
Ext
____________________
_________________
If no employees this quarter, but future employee activity possible, check here
ACCOUNT NUMBER:
and sign the return below. (Lines 1 through 13 do not need to be completed.)
FOR QUARTER ENDING:
Permanently ceased having employees on ______________________________
Ceased all business activity on ________________________________________
DUE ON OR BEFORE:
QUARTERLY WAGES
TAX DUE
1.
TOTAL GROSS WAGES EARNED BY ALL EMPLOYEES FOR
1(a)
$
=
X .0145
WORK PERFORMED WITHIN LOUISVILLE METRO, KY
$
2.
TOTAL GROSS WAGES EARNED BY NON-RESIDENT
EMPLOYEES FOR WORK PERFORMED WITHIN LOUISVILLE
$
METRO, KY
3.
LINE 1 – LINE 2 = TOTAL GROSS WAGES EARNED BY
3(a)
RESIDENT EMPLOYEES FOR WORK PERFORMED WITHIN
$
$
X .0075
=
LOUISVILLE METRO, KY
4.
KENTUCKY JOBS DEVELOPMENT AUTHORITY CREDIT FOR
X _______%
4(a
)
$
=
WAGES EARNED IN LOUISVILLE METRO, KY
$
Enter applicable rate
*
(See Rate Calculation below)
5. TOTAL TAX DUE
$
RECONCILIATION
[Line 1(a) + Line 3(a) – Line 4(a)]
This section should be completed by only those employers who are
required to make monthly deposits. This applies to employers who paid
6. PENALTY & INTEREST
$
license fees totaling more than $3,000.00 during
any one of the preceding
four (4) calendar quarters.
Figures on Lines 8A-8C must reflect the
7. TOTAL AMOUNT DUE
amount that should have been paid for each month and should be equal
$
(Line 5 + Line 6)
to the Total Tax Due (Line 5).
(8.) A
(8.) B
(8.) C
9. TOTAL DEPOSITS PAID
$
FOR THE QUARTER
ST
ND
RD
AMOUNT DUE 1
MONTH
AMOUNT DUE 2
MONTH
AMOUNT DUE 3
MONTH
*
RATE CALCULATION
10. ADDITIONAL PAYMENT DUE
$
(If Line 7 > Line 9)
.5000%
LOUISVILLE METRO
JEFFERSONTOWN
.2775%
11. OVERPAYMENT TO BE
SHIVELY
.2775%
$
CREDITED TO NEXT QUARTER
ST. MATTHEWS
.3125%
WEST BUECHEL
.3125%
12. OVERPAYMENT TO BE
$
REFUNDED
13. ACH CREDIT TRACKING NUMBER
(IF APPLICABLE)
This is to certify that the information shown on this return is true and correct to the best of my knowledge.
___________________________________________________________________
Title: ________________________
Authorized Signature
___________________________________________________________________
Date: ________________________
Print Name
MAILING ADDRESS: P.O. BOX 35410 • LOUISVILLE, KENTUCKY 40232-5410
Telephone: (502) 574-4860 • • Fax: (502) 574-4818 • • TDD: (502) 574-4811
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