Schedule Utc - Kentucky Unemployment Tax Credit
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1
2UTC
Taxable Year
SCHEDULE
*1500030020*
Ending
42A740-UTC (10-15)
__ __ / __ __
Commonwealth of Kentucky
DEPARTMENT OF REVENUE
Mo.
Yr.
U
T
C
NEMPLOYMENT
AX
REDIT
➤ See instructions.
KRS 141.065
➤ Attach to Form 720, 720S, 725, 740, 740-NP , 741, 765 or 765-GP .
Name of Entity
Social Security Number
__ __ __ – __ __ – __ __ __ __
Street Address
Apt. Number
Federal Identification Number
__ __– __ __ __ __ __ __ __
City
State
ZIP Code
Kentucky Corporation/LLET Account Number
__ __ __ __ __ __
PERSONS EMPLOYED
Enter below the name(s), Social Security number(s) and Office of Employment and Training Certificate number(s) of
employee(s) for whom you are claiming a credit. Also enter the date employed and the last date employee was on your
payroll during the tax year.
Employment Dates
Office of
Employment
Date
Date Employed
Employee’s Name
Social Security Number
and Training
Employed
Through
Certificate Number
Mo. Day
Yr.
Mo. Day
Yr.
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24. Enter total number of employees listed above ....................................................................................
24
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