Family Limited Partnership Annual Informational Questionnaire Form - Louisville Metro Revenue Commission
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2DO NOT STAPLE FORMS
FOR OFFICIAL USE ONLY
LOUISVILLE METRO REVENUE COMMISSION
FAMILY LIMITED PARTNERSHIP ANNUAL INFORMATIONAL QUESTIONNAIRE
ACCOUNT NUMBER
Name
_______________________________________________________________________________
Address
_______________________________________________________________________________
FOR YEAR ENDING
MM
DD
YY
City
____________________________________________________
State
Zip
_________
__________
Federal ID
______________________________
Phone No.
______________________
Ext
__________
For the purposes of this Questionnaire, a Family Limited Partnership is defined as: Any family-owned non-
corporate entity where the sole activity of such entity is the production of investment income and as such is
exempted from Occupational License Tax. INVESTMENT INCOME means and includes gross receipts
derived from dividends, interest, annuities, and sales or exchanges of stock or securities to the extent of any
gains therefrom. FAMILY-OWNED is defined as at least 95% of the equity of such entity is owned by
members of the family, which means, with respect to an individual, only:
(i) An ancestor of such individual;
(ii) The spouse or former spouse of such individual;
(iii)A lineal descendent of such individual, of such individual's spouse or former spouse, or of a parent of
such individual, including a legally adopted child of such individual;
(iv) The spouse or former spouse of any lineal descendent described in (iii); or
(v) The estate or trust of a deceased individual who, while living, would have been categorized as any of the
above.
An annual informational return must be filed in order to qualify for this exemption.
1. What is the full legal name of the Family Limited Partnership:
___________________________________________________________________________________
2. The street and mailing address of the designated office of the Family Limited Partnership is:
___________________________________________________________________________________
___________________________________________________________________________________
3. The date of the execution of the Family Limited Partnership Agreement or other organizational
document is: ___________________________. Please attach a copy of said agreement.
4. The date of the latest amendment of the Family Limited Partnership Agreement is:
___________________________. Please attach a copy of each and every amendment.
5. Please attach a list of the Family Limited Partnership’s General and Limited partners, including mailing
addresses.
MAILING ADDRESS: P.O. BOX 35410 LOUISVILLE, KENTUCKY 40232-5410
Telephone: (502) 574-4860 Fax: (502) 574-4818 TDD: (502) 574-4811
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