Form 740np-Wh - Kentucky Nonresident Income Tax Withholding On Distributive Share Income Report And Composite Income Tax Return - 2015

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2015
740NP-WH
*1500010292*
40A201 (10-15)
Commonwealth of Kentucky
Taxable Year Ending
DEPARTMENT OF REVENUE
KENTUCKY NONRESIDENT INCOME TAX WITHHOLDING ON
__ __ / __ __
DISTRIBUTIVE SHARE INCOME REPORT AND COMPOSITE INCOME TAX RETURN
Mo.
Yr.
(To be completed by a Pass-through Entity Only)
KRS 141.206
➤ See instructions.
Taxable period beginning _____/_____/2015, and ending _____/_____/201_____.
A Name of Pass-through Entity
B Federal Identification Number
C Kentucky Corporation/LLET
Number and Street
Account Number (if applicable)
City
State
ZIP Code
D Check applicable Boxes: ¨  Nonresident Income Tax Withholding on Distributive Share Income Report
¨  Change of name
  ¨  Amended - Nonresident Income Tax Withholding on Distributive Share Income Report
¨  Composite Income Tax Return
  ¨  Amended - Composite Income Tax Return
¨  Change of address
¨  Change of accounting period
¨  Final return
(1) Number of nonresident individuals, estates, trusts and corporations included in this withholding
1
(2) Number of nonresident individuals, estates, trusts and corporations exempt from this withholding
2
(3) Number of nonresident individuals, estates, and trusts included in this composite income tax return
3
(4) Kentucky distributive share income subject to withholding or included in the composite income tax
return before apportionment
4
00
%
(5) 100% or the apportionment fraction from the pass-through entity’s Schedule A, Section I, line 12
5
(6) Kentucky distributive share income subject to withholding or included in the composite income tax
return (line 4 multiplied by line 5)
6
00
(7) Tax before tax credits (line 6 multiplied by .06 (6%))
7
00
(8) Enter the partners’, members’ or shareholders’ nonrefundable tax credits
8
00
(9) Kentucky income tax liability (line 7 less line 8)
9
00
(10) Estimated tax payments
¨ 
Check if Form 740NP-WH-P attached
10
00
(11) Extension payment
11
00
(12) Prior year’s tax credit
12
00
(13) Total Payments (lines 10 through 12)
13
00
(14) Income Tax Due (line 9 less line 13)
14
00
(15) Income tax overpayment (line 13 less line 9)
15
00
(16) Credited to 2015 Interest
16
00
(17) Credited to 2015 Penalty
17
00
(18) Credited to 2016
18
00
(19) Amount to be refunded (line 15 less lines 16 through 18)
REFUND 19
00
OFFICIAL USE ONLY
TAX PAYMENT SUMMARY
Make check(s) or money
V
(Round to nearest dollar)
order(s) payable to:
A
Kentucky State Treasurer
L
.00
Tax (Line (14))
$_____________________________
1.
#
Mail to:
Interest
.00
2.
$_____________________________
P
Kentucky Department of Revenue
W
Penalty
.00
3.
$_____________________________
Frankfort, KY 40619-0006
2
0
Total Payment
$_____________________________
4.
.00
4
I, the undersigned, declare under the penalties of perjury, that I have examined this return, including all accompanying schedules
and statements, and to the best of my knowledge and belief, it is true, correct and complete.
Print name of partner, member or shareholder
Signature of partner, member or shareholder
Daytime telephone number
Date
May the DOR discuss this return with the preparer?
Yes
No
Name of person or firm preparing return
Date
Email Address:
Telephone No.:
SSN, PTIN or FEIN

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