Net Profit License Tax Return Form - City Of Pikeville printable pdf download

hc019602 pikeville_hcf7533-pikeville 12/17/09 12:38 PM Page 1

Form 228 Revised 12/2009

CITY OF PIKEVILLE OCCUPATIONAL TAX

NET PROFIT LICENSE TAX RETURN

***This form must be completed in its entirety. If Federal I.D. or Social Security Number is omitted, this form will be

returned to you. If address change applies, you must check the address change box.***

CHECK IF:

____ ADDRESS CHANGE

____ AMENDED RETURN

____ NO ACTIVITY

____ INITIAL RETURN

ALL RETURNS RECEIVED WITHOUT PROPER SIGNATURES WILL BE ASSESSED A $20.00 SERVICE CHARGE.

FISCAL YEAR ENDED

Name and Address of Business

ACCOUNT NUMBER

Mo.

Day

Year

Daytime Phone Number __________________________________

PLEASE NOTIFY THIS OFFICE OF ANY CHANGE IN OWNERSHIP OR NAME AND ADDRESS SHOWN ABOVE

CHECK IF “FINAL RETURN” Date Operations ceased:____________ (Required to close account.)

* ALL LICENSEES MUST ANSWER THE QUESTIONS BELOW*

A. Principle business activity:

___________________________________________________________________________________________

B. During the past year did Federal Authorities change or propose to change net income reported for that year or any prior year?

_________

If YES, which year(s) was adjusted? _____________________________________(Attach statement of changes)

C. Principle owner/administrative officer: _________________________________________________________________________________________________

Address:___________________________________________________________________________________________________________________________

D. Did you file a consolidated return?

__________ (If yes, see instructions)

E. Was business activity discontinued?

__________

When?

___________

For Dissolution_______________ or Sale / Transfer? ______________

If sale / transfer state successor

_________________________________________________________________________________________________

name and address:

_________________________________________________________________________________________________

YES_____ NO_____ Did you make payments in the sum of $600.00 or more to any individual for services rendered in City of Pikeville other

than an employee? IF YES, YOU ARE REQUIRED TO FILE COPIES OF FEDERAL FORM 1099.

* ALL LICENSEES MUST COMPLETE PAGE 2 OF THIS FORM BEFORE COMPLETING THIS SECTION*

PART I - TAX COMPUTATION

1. Enter ADJUSTED NET PROFIT (From line 14 on the back of this form):

2. Enter percentage from Line 17 or 18 page 2

3. Net Profits Allocation (Line 1 X Line 2)

4. License Tax (Line 3 X 2%)

5. City Minimum License Tax (Non-refundable) (See Instructions)

6. License Tax Due (the greater of Line 4 or Line 5)

7. Credits: Estimated Payments

8. License Tax Due (Line 6 minus Line 7)

9. Penalty - 5% per month, not to exceed 25% - Minimum $25.00

Penalty due on amount owed from original due date, unless appropriate estimated payments were made.

10. Interest - 12% per annum

Calculate interest on amount owed on Line 8 from original due date

11. Total amount due (overpaid) (total line 8 thru 10)

12. Overpayment

_______ Credit

_______ Refund

I hereby certify, under penalty of perjury, that the statements made herein and any supporting schedules are true, correct, and complete to the best of my knowledge.

Preparer Signature (Return must be signed.)

Date

Taxpayer Signature (Return must be signed.)

Date

Print Name

Federal ID

Print Name

Address

Phone No.

Title

Social Security No.

If you have questions concerning this form visit or call (606) 437-5105

Make check payable to:

OCCUPATIONAL TAX ADMINISTRATOR

Mail this form along with supporting schedules to:

CITY OF PIKEVILLE

DIVISION OF TAX COLLECTION

118 COLLEGE STREET

PIKEVILLE, KY 41501

This return must be filed and paid in full by the fifteenth day of the fourth month after the close of the fiscal/calendar year, unless an extension of time to file has been granted.

Net Profit License Tax Return Form - City Of Pikeville

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