Form 62a601 - Foreign Savings And Loan Tax Return - 1999

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62A601 (11-99)
Commonwealth of Kentucky
FOREIGN SAVINGS AND LOAN TAX RETURN
REVENUE CABINET
Department of Property Valuation
200 Fair Oaks Lane, Station 32
As of January 1, _______
Frankfort, KY 40620
File by January 31. Tax due on or before July 1 succeeding filing of return.
Name and Address of Kentucky Branch
Address of Headquarters
Fein No. _____________________________
I.
Capital to be Apportioned within Kentucky
A. Undivided profits ....................................................................................... $ _________________
B. Surplus .........................................................................................................
_________________
C. General reserves ..........................................................................................
_________________
D. Paid-up stock ...............................................................................................
_________________
E. Total (Add lines A, B, C and D) .................................................................
$ _________________
II.
Apportionment Factor
A. Receipts factor
1a. Total Kentucky receipts ....................................................................... $ _________________
2a. Total receipts wherever located (include KY receipts) .....................
_________________
3a. Kentucky receipts factor (divide line 1a by line 2a) ..........................
_________________
B. Loan factor
1b. Add balance of KY loans as of January 1 and December 31 ............ $ _________________
2b. Divide Kentucky loans reported on line 1b by 2 ...............................
_________________
3b. Add balance of all loans on January 1 and December 31 .................
_________________
4b. Divide all loans reported on line 3b by 2 ...........................................
_________________
5b. Kentucky loan factor (divide line 2b by line 4b) ...............................
_________________
C. Payroll factor
1c. Total Kentucky payrolls ...................................................................... $ _________________
2c. Total all payrolls (include officers salaries) ........................................
_________________
3c. Kentucky payroll factor (divide line 1c by line 2c) ...........................
_________________
D. Total factors (add lines 3a, line 5b and line 3c) .........................................
_________________
E. Kentucky apportionment factor (divide line D by 3) ..............................
_________________
$ _________________
III. Capital Apportioned to Kentucky
A. Kentucky capital reported in Section I, line E .......................................... $ _________________
B. Multiplied by KY apportion factor reported in Section II, line E ............
_________________
C. Equals total capital apportioned to Kentucky ..........................................
$ _________________
IV.
Kentucky Deposits
A. Total deposits maintained in Kentucky .................................................... $ _________________
B. Less amounts borrowed that equal or exceed member paid amount ....
_________________
C. Equals total deposits maintained in Kentucky .........................................
$ _________________
V.
Total Kentucky Capital
A. Capital reported in Section III line C ......................................................... $ _________________
B. Plus deposits reported in Section IV line C ..............................................
_________________
C. Equals total Kentucky capital ....................................................................
_________________
D. Less US government securities influence (Schedule B, Form 62A601-S)
_________________
E. Equals taxable Kentucky capital ................................................................
$ _________________
VI. Tax Due
A. $1 for each $1,000 of Section V, line E ........................................................
$ _________________
I, the undersigned, do solemnly swear that the above report, including accompanying schedules, is to the best of my knowledge and belief
a true and correct report.
________________________________________________________
____________________________________________
Signature of Authorized Agent
Phone Number
________________________________________________________
____________________________________________
Title
Date

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