City Of Madisonville Kentucky - Net Profit License Fee Return Form printable pdf download

CITY OF MADISONVILLE KENTUCKY - NET PROFIT LICENSE FEE RETURN

Section A

Account Number

Fiscal Year End

1. Circle Appropriate: Corporation, Partnership, Individual Owner, Fiduciary

2. Social Security and/or Federal ID Number(s) ______________________________

3. Nature of Business __________________________________________________

4. Did you have employees working in the City limits this year? Yes No

Date Received

5. Have Federal Authorities changed the net income as originally reported for any

Check Number

prior years? Yes No

Check Amount

6. Business Phone

Home Phone ___________________

Please enter the following:

7: Business Date(s):

Started

____________

Business Name:

Discontinued

____________

Successor __________________

Business Address:

8. List additional businesses operated

subject to Madisonville License Fee.

City, State, Zip:

____________________________

Section B

*Enclose one copy of Federal Return & Applicable Schedules (See Instructions)

9. Total Gross Income per attached Return

10. Total Deductions per attached Return

11. Net Income per attached Return

12. Add items not deductible (Line H, Section C)

13. Total (Line 11 plus Line 12)

14. Deduct Items Not Subject (Line N, Section C)

15. Adjusted Net Income (Line 13 less Line 14)

16. If Section D (Line R) is used enter Average Percentage

0.0000%

17. Net Profits subject to License Fee (Line 15 X Line 16)

18. Madisonville License Fee (Line 17 X .015)

19. Credits - Minimum License Fee

and/or Estimated Payments

20. Balance (Line 18 less Line 19)

21. Interest 1% per month or portion of month

22. Penalty 5% per month or portion of month not to

exceed 25% Until Paid In Full, $25.00 minimum

Make Check Payable & Mail to:

(Penalty waived per approved City

Finance Director

Extension date of ________________ )

City of Madisonville

23. Total Due (Line 20 plus Line 21 plus Line 22)

P.O. Box 1270

0.00

PAY THIS AMOUNT

Madisonville KY 42431

Section C

Items Not Deductible - Add

Items Not Subject - Deduct

A. State or Local taxes

I. Interest Income

B. License Fee under this Ordinance

J. Dividends

C. Net loss from Capital Assets

K. Net Gain from Capital Assets

D. Ordinary Losses (Form 4797)

L. Ordinary Gains (Form 4797)

E. Net Operating Loss Deduction

M. Other Items (Attach Schedule)

F. Partners Salaries (Attach Schedule)

Total Deductions

(Enter on Line 14)

G. Other Items (Attach Schedule)

H. Total Additions (Enter on Line 12)

Schedule D

Allocation Factors

Column A Madisonville

Column B Total

Column C Pct

O. Gross Income (If not applicable write N/A in Column C)

0.0000%

P. Total Wages & Salaries (If not applicable write N/A Col C)

0.0000%

Q. Total Percents (Line O plus Line P)

0.0000%

R. Average Percentage (Line Q divided by number of applicable percents)

Enter on Line 16

0.0000%

I hereby Certify that the Statements Made Herein and In Any Supporting Schedules are True, Correct, and Complete to the Best of My Knowledge.

Return Must

Be Signed

Signature of Individual Preparing Return

Date

Signature of Taxpayer

Date

This return must be filed and paid in full within 105 days after close of fiscal year.

City Of Madisonville Kentucky - Net Profit License Fee Return Form

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