Kentucky Mercer County Net Profits License Fee Return
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2MCNP – Form 02A
MERCER COUNTY NET PROFITS LICENSE FEE RETURN
This return is due on or before April 15 for the Calendar Year or within 105 days of the end of your Fiscal Year.
Name and Address of Business or Licensee
Account No.
Calendar or
Fiscal Year Ended
Make payments to:
Month
Day
Year
Mercer County Fiscal Court
Mail to:
Did you have employees
Mercer County Tax Administrator
In Mercer County?
P.O. Box 265
ٱYes
ٱNo
Harrodsburg, KY 40330
Mark changes, if needed
(859)734-6300
ALL LICENSEES MUST ANSWER FULLY THE QUESTIONS BELOW:
A. Nature of Business _______________________________________
Did you make payments in the
B. Federal I.D. or Social Security # _____________________________
sum of $600 or more to any
C. During the past year, did Federal Authorities change or propose to
individual for services
change net income reported for that year or any prior year?
performed in Mercer County?
ٱYes
ٱNo
(other than an employee)
ٱYes
ٱNo
If yes, attach schedule of changes for each year
D. If Organization was discontinued, state when ___________________
If yes, you are required to file
ٱDissolution
ٱSale
Form 1099 and remit a
If by Sale, Name and Address of New Owner
copy to the Mercer County
_______________________________________________________
Tax Administrator
_______________________________________________________
E. Date Business Started in Mercer County ______________________
MERCER COUNTY SCHEDULE
1. Net Profit per Worksheet A
______________________
2. Worksheet B, Column C or 100%
______________________
3. Mercer County Net Profit (Line 1 x Line 2)
______________________
4. Mercer County License Fee (Line 3 x .45%)
______________________
5. Estimated payments/credits
______________________
6. Gross Due (Line 4 minus Line 5)
______________________
7. Penalty (5% per month or portion thereof, not to exceed 25%)
$25.00 MINIMUM PENALTY
______________________
8. Interest (12% per annum simple interest)
______________________
9. Total License Fee Due
______________________
I HEREBY CERTIFY THAT THE STATEMENTS MADE HEREIN AND IN ANY SUPPORTING SCHEDULES ARE TRUE,
CORRECT, AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
________________________________________________
________________________________
_______________
Signature of Taxpayer
Title
Date
________________________________________________
_______________________
Signature of Individual Preparing Return
Date
YOU MUST ATTACH A COMPLETE COPY, INCLUDING ALL ATTACHMENTS, OF YOUR FEDERAL RETURN AS
APPLICABLE.
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Parent category: Financial