725
A
__ __ __ __ __ __
*1500030270*
41A725
Kentucky Corporation/LLET Account Number
Department of Revenue
K
S
M
LLC
ENTUCKY
INGLE
EMBER
2015
I
O
I
NDIVIDUALLY
WNED
NCOME
➤ See instructions.
AND LLET R
ETURN
Taxable period beginning ______________ , 201 ___, and ending ______________ , 201 __ .
B
Check applicable box(es):
__ __ – __ __ __ __ __ __ __
C
Federal Identification Number
__ __ / __ __
Taxable Year Ending
LLET
__ __ __ – __ __ – __ __ __ __
Mo.
Yr.
Social Security Number
Receipts Method
Kentucky Secretary of State
Name of LLC
Gross Receipts
Organization Number
Gross Profits
Name of Owner
$175 minimum
State and Date of Organization
Number and Street
Nonfiling Status
Code
Principal Business Activity in KY
City
State
ZIP Code
Telephone Number
Enter Code
D
Check if applicable:
Qualified investment pass-through entity
I nitial return
NAICS Code Number
Final return (Complete Part IV)
Amended return (Complete Part V)
Change of name
(Relating to Kentucky Activity)
(See )
Short-period return (Complete Part IV)
Change of address
Change of accounting period
______ ______
E
Check applicable box:
Composite return (attach Schedule CP)
Single return
PART I—KENTUCKY NET DISTRIBUTABLE INCOME
PART II—LLET COMPUTATION
1. Ordinary income (loss) ..................
1
1. Schedule LLET, Section D, line 1 ...
1
00
00
2. Net income (loss) from rental real
2. Tax credit recapture .......................
2
00
3
estate activities ...............................
2
00
3. Total (add lines 1 and 2) ................
00
3. Net income (loss) from other
4. Nonrefundable LLET credit from
rental activities ...............................
3
Kentucky Schedule(s) K-1 ..............
4
00
00
4
4. Interest income ..............................
00
5. Nonrefundable tax credits (attach
5
00
5. Dividend income ............................
5
Schedule TCS) .................................
00
00
6. Royalty income ..............................
6
6. LLET liability (greater of line 3 less
lines 4 and 5 or $175 minimum) .....
6
00
7. Net short-term and long-term
7
00
capital gain (loss). If net (loss),
7. Estimated tax payments ................
8
00
do not include more than
8. Certified rehabilitation tax credit ..
($3,000) ...........................................
7
00
9. Film industry tax credit ..................
9
00
00
10
00
8. Section 1231 net gain (loss) ..........
8
10. Extension payment ........................
9
9. Other income (attach schedule) ......
00
11. Prior year’s tax credit .....................
11
00
10. Other deductions (attach schedule)
10
12. LLET due (line 6 less lines 7 through 11)
00
12
00
11. Total net distributable income
13. LLET overpayment (lines 7
00
00
13
(lines 1 through 9 less line 10) ......
11
through 11 less line 6) ....................
00
14
12. Enter 100% or the apportionment
14. Credited to 2015 Interest ...............
00
15
fraction from Schedule A, Section
15. Credited to 2015 Penalty ................
00
%
I, line 12 (attach schedule) ..............
12
16. Credited to 2016 LLET ....................
16
00
17. Amount to be refunded .................
17
TAX PAYMENT SUMMARY
OFFICIAL USE ONLY
(Round to nearest dollar)
P
W
LLET
2
.00
1. LLET due (Part II, line 12)
$_____________________________
0
4
.00
2. Interest
$_____________________________
V
.00
3. Penalty
$_____________________________
A
L
.00
4. Total Payment
$_____________________________
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