Annual Gross Receipts License Fee Return - City Of Franklin, Ky - 2012
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1
2THE CITY OF FRANKLIN, KY
2012 ANNUAL GROSS RECEIPTS LICENSE FEE RETURN
REMIT BY 4-15-2013
GENERAL INSTRUCTIONS:
ALL ITEMS ON THIS APPLICATION MUST BE ANSWERED. FAILURE TO DO SO WILL DELAY THE PROCESSING OF YOUR APPLICATION
AND COULD RESULT IN A PENALTY CHARGE. INSTRUCTIONS ARE PROVIDED FOR YOUR ASSISTANCE.
«BUSINESS_NAME»
«ADDRESS»
«CITYSTATE» «ZIP»
ACCOUNT # «ACCT_»
PLEASE PRINT OR TYPE ALL ANSWERS
1. NAME OF BUSINESS______________________________________________________________________________________________________________________________
2. MAILING ADDRESS____________________________________________________________CITY________________________________STATE_______ ZIP________________
3. BUSINESS PHONE: (
) _______________________________ FAX: (
) _______________________________
4. OWNERSHIP
PROPRIETORSHIP
(OWNER’S SSN)
___________________________________________________________________________
PARTNERSHIP
(PARTNER’S NAME & SSN)
___________________________________________________________________________
CORPORATION
(PRESIDENT’S NAME & FEIN)
___________________________________________________________________________
5.
DO YOU HAVE EMPLOYEES WORKING IN FRANKLIN?
YES
NO
IF YES, UNDER WHAT COMPANY NAME IS PAYROLL PAID? _______________________________________
6. FRANKLIN LOCATION (
) AND PHONE IF DIFFERENT FROM ABOVE_________________________________________
S
7. CALCULATIONS:
A. TOTAL GROSS RECEIPTS (
)
CALENDAR YEAR
FISCAL YEAR
A$_____________________
SEE INSTRUCTIONS ON REVERSE
OR
RECEIPTS BASED ON PERIOD ______________ TO _______________
B. A
D
(ALL RECEIPTS IN CITY)
LLOWABLE
EDUCTIONS
SALES TAX
$_____________________
RETURNS
$_____________________
LIQUOR SALES
$_____________________
OUTSIDE CITY
SEE INSTRUCTIONS FOR APPORTIONMENT
ON BACK
B $________________________
OR (
C. TOTAL GROSS RECEIPTS SUBJECT TO LICENSE FEE (
A
B)
6
)
C $________________________
LINE
MINUS LINE
TOTAL FROM LINE
ON BACK IF APPORTIONMENT REQUIRED
.0006
D. LICENSE FEE
UP TO $1,000,000 MULTIPLIED BY
_______________________
.0001
(LINE C MULTIPLIED BY RATE) 1,000,001 THRU 10,000,000 MULTIPLIED BY
_______________________
00005
EXCESS MULTIPLIED BY .
_______________________
DEDUCT 2012 PREPAID MINIMUM FEE
(_______________)
D $_______________________
E. PENALTY 5% PERCENT OF FEE/MONTHLY/ MINIMUM $25 (SEE INSTRUCTIONS OF PAGE 2)
E $________________________
.
12%
FEE/
(
PAGE 2
F
INTEREST
PERCENT OF
ANNUALLY
SEE INSTRUCTIONS ON
)
F $________________________
. TOTAL DUE
G
MAKE CHECK PAYABLE TO
CITY OF FRANKLIN
G $________________________
(ADD LINE D+E+F)
AND MAIL TO
P O BOX 2805
FRANKLIN, KY 42135-
PHONE (270) 586-4497
IF NO LONGER IN BUSINESS, ENTER CLOSING DATE
______/_______/_______
I AFFIRM THAT THIS RETURN (INCLUDING ANY ACCOMPANYING STATEMENTS) HAS BEEN EXAMINED BY ME, AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, IS A
TRUE, CORRECT AND COMPLETE RETURN, MADE IN GOOD FAITH, PURSUANT TO THE ORDINANCE 220.7-6-2008
_________________________________________________
____________________________________________
________________________
SIGNATURE OF OWNER/PARTNER/CORPORATE OFFICER
NAME/PREPARED BY
DATE
THE CITY OF FRANKLIN REQUIRES THE CORRECT FEDERAL TAX FORM AND PROPER PAYMENT.
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