Form 101 - City Of Shively Legal Form
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1CITY OF SHIVELY
Please use this number on
correspondence concerning
3920 DIXIE HIGHWAY
your account.
SHIVELY, KENTUCKY 40216
#
IDENTIFICATION NUMBER
NAME OF BUSINESS ___________________________________________________
ADDRESS ____________________________________________________________
This is to affirm under penalty of perjury that my gross receipts in Shively, Kentucky, as
listed in my Federal Income Tax Return for _____ were $ _________________________
Signature _______________________
Title ___________________________
Date ___________________________
BUSINESS HAVING GROSS RECEIPTS OF
1. Less than $25,000.00
$50.00 MINIMUM
2. $25,000.01 to $99,999.99
$2.00 per 1000 or fraction
3. $100,000.00 to $199,999.99
$198.00 Plus $1.434 per $1000 or fraction
4. $200,000.00 to $450,999.99
$340.00 Plus $1.00 per $1000 or fraction
Under Ordinance #13, Series 1986, Maximum tax is $590.00
Loan company ......................................$340.00
Auto wreckers ....................................... 255.00
Garbage collector ................................. 170.00 plus license fee
Distilled alcohol ..................................... 170.00
Professional ..........................................
85.00
Real estate broker .................................
85.00
Real estate salesperson ........................
50.00
Insurance company ...............................
50.00
Hotel or motel ........................................
5.10
per unit plus license (exempts room
rental from gross receipts)
Billboards ...............................................
50.00 ea.
Pawn Shop ............................................ 460.00
The 590.00 maximum tax computed under the Gross Receipts of business entity approach of Ordinance #9 Series 1990
is subject to the Net Receipts computation required by said Ordinance. If the Net Receipts approach yields a higher figure,
that amount must be paid under Ordinance #9 Series 1990.
NOTE:
Receipts from the sale of alcoholic beverages and hotel or motel room rentals are not to be included in gross
receipts. It is understood that the City of Shively has an occupational license fee on net profits from business
conducted within the City. A minimum license fee must be paid and an annual return filed whether or not the
business has shown a profit. It is also understood that the occupational tax 1.50% must be withheld from
earnings of employees and remitted to the City quarterly. Reports due 105 days following the end of your fiscal
year or calendar year.
(OVER)
101 02/08
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