Boone County Fiscal Court
2950 Washington Street
PO Box 960
Burlington, KY 41005
(859) 334-2144
(859) 334-3914 fax
Amended Quarterly Withholding Tax Return for 2008
Name:
Account #: ________________________________________
dba:
FEIN/SSN:_________________________________________
(please advise if incorrect)
For Quarter Ending: - (Circle Correct Date)
Address:
03/31/08 due 04/30/08
09/30/08 due 10/31/08
City, State, Zip:
06/30/08 due 07/31/08
12/31/08 due 02/02/09
Original
Amended
Total Gross Earnings of All Employees Working in Boone County
$
$
Boone County Board of Education Tax - 1/2 of 1% (.005)
*****No Maximum*****
Original
Amended
1) Gross earnings subject to Boone County Board of Education tax
$
$
2) Multiply Line 1 - by 1/2 of 1% (.005)
$
$
3) Late fee penalty 1% per month, 12% per year
$
$
4)
Less credit for overpayment in prior quarter-attach explanation
$
$
Difference
5) Total Board of Education Tax
$
$
Boone County Ordinance #430-1A - 8/10 of 1% (.008)
*****Max $51,257.00/tax of $410.06*****
Original
Amended
6) Gross earnings subject to Boone County payroll tax
$
$
7) Multiply Line 6 - by 8/10 of 1% (.008)
$
$
8) Interest Fee 1% per month, 12% per year
$
$
9)
Less credit for overpayment in prior quarter-attach explanation
$
$
10)
Less any KY Job Assessment Program credit
$
$
Difference
11) Total Boone County Ordinance Tax
$
$
Boone County Mental Health Tax - 15/100 of 1% (.0015)
*****Max $16,666.00/tax of $25.00*****
Original
Amended
12) Gross earnings subject to Mental Health Payroll tax
$
$
13) Multiply Line 12 by 15/100 of 1% (.0015)
$
$
14) Interest Fee 1% per month, 12% per year
$
$
15)
Less credit for overpayment in prior quarter-attach explanation
$
$
Difference
16) Total Mental Health Tax
$
$
Total remittance (add lines 5,11,16)
Make check payable to: Boone County Fiscal Court
$
Statistical Information-REQUIRED
Total Number of Employees Working in Boone County
Total Number of Employees Required to Pay Board of Education Tax
Signed:
Date:
Official Title:
Telephone Number:
Tax Form Prepared By:
I declare, under the penalties of perjury, that I have examined this document and to the best of my knowledge and belief, this is a true and accurate return.
Please notify in writing any changes of ownership or new address by completing a Request to Change/Close Occupational License Account which can be found
on our website @ If you have any questions please call 859-334-2144 or email
Make check payable to: Boone County Fiscal Court
Mail your return to:
Mail your return to:
(PO Box 457, Florence, KY 41022-0457) are for returns WITH PAYMENT and
(PO Box 960, Burlington, KY 41005-0960) are for returns WITHOUT PAYMENT
Form 2306