Gross Receipts Tax Form - City Of Wilder, Kentucky

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* SEE EXTENSION FILING INSTRUCTIONS BELOW
* LICENSEE, NOT PREPARER, RESPONSIBLE FOR
ALL INFORMATION AND PAYMENTS
* FILING INSTRUCTIONS INSIDE
* QUESTIONS OR ASSISTANCE CALL (859) 581-8884
* MAKE CHECK PAYABLE TO:
CITY OF WILDER
CITY OF WILDER
FISCAL YEAR ENDS
GROSS RECEIPTS
520 LICKING PIKE
_________________
TAX FORM
WILDER, KY 41071
COMPANY:
EXTENSION REQUEST FILING INSTRUCTIONS
* FOR A SIX MONTH EXTENSION, MAKE A COPY OF THIS FORM AND
PAY AT LEAST 90% OF ANY ESTIMATED FEES DUE
* SIGN RETURN AND REMIT BY DUE DATE
COL. 1 COL. 2
COL. 3
COL. 4
COL. 5
FEE LIMITS
COL. 6
COL. 7
COL. 8
MIN
/
MAX
CITY
FEE
SUBJECT
RATE
FEE
FEE
EST. TAX
TOTAL
.00 / 40,000.00
EARNINGS
AMOUNT
DUE
PAYMENT
FEE DUE
Wilder Gross
0.00075
RETURN MUST BE SIGNED -
TOTAL
I hereby certify under penalty of perjury, that the
statements made herein and in any supporting schedules are true, correct and complete
5% Per Month or
to the best of my knowledge.
Portion Thereof
PENALTY
Not to exceed 25%
TOTAL X .000247
SIGNATURE OF INDIVIDUAL PREPARING FORM
DATE
x # Days Past
INTEREST
PRINT NAME
PHONE NUMBER
Due Date
SIGNATURE OF LICENSEE
DATE
TOTAL AMOUNT DUE
PRINT NAME
TITLE
DUE WITHIN FOUR (4) MONTHS FROM
PLEASE PRINT FEDERAL ID # OR SOCIAL SECURITY #
THE END OF YOUR FISCAL YEAR.
HAVE YOU ATTACHED ALL APPLICABLE FEDERAL FORMS,SCHEDULES,STATEMENTS?

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