LIVINGSTON COUNTY KENTUCKY OCCUPATIONAL TAX 
                                                             TAX YEAR 201 
                                NET PROFIT LICENSE FEE RETURN 
 
FROM BUSINESS, PROFESSION, OR OTHER ACTIVITY WITHIN LIVINGSTON CO, KY CONDUCTED BY CORPORATIONS, PARTNERSHIPS, INDIVIDUALS AND FIDUCIARIES OF 
ESTATES AND TRUST, FARM OWNERSHIP (RESIDENT OR NON-RESIDENT) 
 
                                                                                    MAKE CHECK PAYABLE AND RETURN TO: 
                                                                                    LIVINGSTON COUNTY TAX ADMINISTRATOR 
                                                                                    PO BOX 48 
                                                                                    SMITHLAND KY, 42081 
                                                                                    (270) 928-3361                     
 
PLEASE NOTIFY THIS OFFICE OF ANY CHANGES IN OWNERSHIP, NAME OR ADDRESS SHOWN ABOVE. 
 
SECTION A: SALES AND SERVICES RENDERED ONLY IN LIVINGSTON COUNTY    ALL AMOUNTS ROUNDED TO THE NEAREST DOLLAR           . 
 
1. TOTAL GROSS RECEIPTS/INCOME IN LIVINGSTON COUNTY ……………………………………………………………………….…$_________________________  
 
2. TOTAL EXPENSES IN LIVINGSTON COUNTY…………………………………………………………………………………………..……………..$_________________________ 
 
3. NET PROFIT IN LIVINGSTON COUNTY (LINE 1 LESS LINE 2)………………………………………………………………………..…$_________________________ 
 
4. LIVINGSTON CO. TAX LIABILITY IS 1% OF AMOUNT ON LINE 3…………………………………………………………………...$_________________________ 
 
5. PENALTY 5% PER MONTH, NOT EXCEEDING 25% OF LINE 4 (PENALTY NOT LESS THAN $25)……………………………$_________________________ 
 
6. INTEREST 1% PER MONTH……………………………………………………………………………………………………………………………..……………….$_________________________ 
 
7. BALANCE DUE ( LINE 4, PLUS LINES 5 & 6)…………………………………………………………………………………………………….………..$_________________________ 
 
SECTION B: SALES AND SERVICES RENDERED BOTH INSIDE AND OUTSIDE COUNTY 
 
1. PERCENTAGE OF GROSS RECEIPT IN LIVINGSTON CO TO TOTAL RECEIPTS……………………………….………………$_________________________ 
 
2. PERCENTAGE OF WAGES IN LIV. CO TO TOTAL WAGES……………………………………………………………………………………..$_________________________ 
 
3. AVERAGE PERCENTAGE OF LINE 1 AND LINE 2……………………………………………………………………………………………………….$_________________________ 
 
4. PERCENTAGE OF ENTIRE NET PROFIT SUBJECT TO LIV. CO. OCCUPATIONAL TAX……………………………..….$_________________________ 
 
5. LIVINGSTON CO. TAX LIABILITY IS 1% OF AMOUNT IN LINE 4………………………………………………………..………….$_________________________ 
 
6. PENALTY 5% PER MONTH, NOT EXCEEDING 25% OF LINE 5 (PENALTY NOT LESS THAN $25)……………………….…$_________________________ 
 
7. INTEREST 1% PER MONTH……………………………………………………………………………………………………………………………………………..$_________________________ 
 
8. BALANCE DUE ( LINE 5, PLUS 6 & 7)………………………………………………………………..………………………………………………………….$_________________________  
                                                                 
                                 INSTRUCTIONS ON BACK OF RETURN 
                                                                 
I HEARBY CERTIFY THAT THE INFORMATION PROVIDED HEREIN IS TRUE, CORRECT AND COMPLETE.  PLEASE ATTACH A COPY OF FEDERAL INCOME SCHEDULE USED IN 
COMPLETING YOUR RETURN AS REQUIRED BY THE ORDINANCE. 
 
SIGNATURE_________________________________________PHONE NO______________________________________DATE_____________________ 
 
SOCIAL SECURITY_______________________________________OR FEDERAL TAX ID ____________________________________________________ 
 
PREPARER USE ONLY 
 
SIGNATURE_______________________________________________________________________________________DATE_____________________ 
 
FIRM NAME AND ADDRESS_____________________________________________________________________________________________________ 
 
THIS RETURN MUST BE FILED ON OR BEFORE APRIL 15 TH           OF EACH YEAR OR WITHIN 135 DAYS OF THE CLOSE OF YOUR 
FISCAL YEAR SHOWING NET PROFIT OR NET LOSS. 

                                 NET PROFIT LICENSE FEE RETURN INSTRUCTIONS 
                                                  
GENERAL INSTRUCTIONS 
ANY INDIVIDUAL, PARTNERSHIP, ASSOCIATION, CORPORATION, FIDUCIARY OR OTHER ENTITY ENGAGED IN THE OPERATION OF ANY BUSINESS, 
PROFESSION OR ENTERPRISE IN LIVINGSTON COUNTY KENTUCKY IS SUBJECT TO AN ANNUAL 1 (ONE) PERCENT NET PROFIT LICENSE FEE TAX 
DERIVED FROM BUSINESS, PROFESSION OR OTHER INCOME EARNED IN LIVINGSTON COUNTY UNDER ORDIANCE #101499.  NET PROFIT LICENSE FEE 
TAX IS ASSESSED AT ENTITY LEVEL. 
 
WHO SHOULD FILE 
THE NET PROFIT LICENSE FEE RETURN IS TO BE FILED BY ANY ENTITY HAVING RECEIPTS WITHIN LIVINGSTON COUONTY.  NON-EMPLOYEES 
EARNINGS FROM 1099 MISC ARE SUBJECT TO THE TAX.  RECEIPTS FROM THE RENTAL OF REAL ESTATE AND FARM OPERATION ( CROPS, LIVESTOCK, 
RENT, LEASES, ROYALTIES, USDA, TIMEBER, ETC.) ARE ALSO SUBJECT TO THE 1% NET PROFIT TAX. 
 
EXTENSION REQUEST 
IF AN EXTENSION OF TIME FOR FILING IS NECESSARY, IT WILL BE GRANTED IF A COPY OF YOUR FORM 4868, 2688, OR 7004 IS FAXED OR MAILED BY 
APRIL 15 .  NO PARTIAL PAYMENT IS REQUIRED WITH YOUR REQUEST, AND NO PENALTY WILL BE ASSESSED, HOWEVER ANY BALANCE UNPAID TH
WHEN PAYMENT IS DUE SHALL BEAR INTEREST AT THE RATE OF ONE (1) PERCENT PER MONTH; TWELVE (12) PERCENT PER ANNUM UNTIL PAID. 
 
ACCOUNTING  
A SEPARATE FILING IS REQUIRED FOR EACH SCHEDULE FILED WITH THE FEDERAL GOVERNMENT.  THE LAW AND REGULATIONS OF THE INTERNAL 
REVENUE CODE PERTAINING TO METHODS OF ACCOUNTING FOR FEDERAL INCOME TAX SHALL BE APPLICABLE TO THE METHODS OF ACCOUNTING 
ALLOWED BY LIVINGSTON COUNTY.  THE LICENSEE’S INCOME SHALL BE COMPUTED FOR LIVINGSTON COUNTY LICENSE FEE PURPOSES ON THE BASIS 
OF THE SAME CALENDAR OR FISCAL YEAR REQUIRED BY THE FEDERAL GOVERNMENT.  WHERE A “CASH BASIS”, “ACCRUAL BASIS”, LONG TERM 
CONTACT BASIS” OR SOME HYBRID METHOD IS USED IN FILING FEDERAL INCOME TAX RETURNS, THE SAME METHODS MUST BE USED IN 
REPORTING THE INCOME REPORTABLE FOR LIVINGSTON COUNTY NET PROFIT LICENSE FEE RETURN PURPOSES. 
 
LINE-BY-LINE INSTRUCTIONS 
 
SECTON A: SALES AND SERVICES RENDERED ONLY IN LIVINGSTON COUNTY 
 
LINE 1: GROSS RECEIPTS/ SALES AND OTHER INCOME FROM FEDERAL RETURN SCHEDULE C, E, F (1040), FEDERAL 1041, 1065, 1120, 1120S.  OTHER 
INCOME INCLUDES ALL SUBJECT EARNINGS ON WHICH THE 1% FEE HAS NOT BEEN WITHHELD. 
 
LINE2: ENTER COST OF GOODS SOLD, OPERATING EXPENSES AND OTHER DEDUCTIONS ALLOWED ON FEDERAL RETURN.  ITEMS NOT DEDUCTIBLE A) 
FEDERAL, STATE, AND LOCAL TAXES BASED ON INCOME, B)LIVINGSTON COUNTY LICENSE FEE, C) NET OPERATING LOSS DEDUCTION, D) CAPTIAL 
LOSS, E) SALARIES PAID TO PARTNERS. 
 
LINE 3: SUBTRACT LINE 2 FROM LINE 1. 
 
LINE 4: ENTER 1% OF LINE 3 
 
LINE 5: UP TO 25% PENALTY OF AMOUNT DUE ON LINE 4, IF NOT MAILED BY DUE DATE.  NOTE SEE EXTENTION REQUEST. 
 
LINE 6: INTEREST WILL BE ASSESSED AT 1% PER MONTH, 12% PER ANNUM, ON AMOUNT DUE ON LINE 4 IF NOT MAILED BY DUE DATE. 
 
LINE 7:  LINE 4 PLUS LINES 5 & 6 ( IF APPLICABLE) IS THE AMOUNT DUE WITH RETURN. PLEASE SIGN AND RETURN Y0UR FORM. 
 
SECTION B:  SALES AND SERVICES RENDERED BOTH INSIE AND OUTSIDE COUNTY. 
 
LINE 1: TOTAL GROSS RECEIPTS IN LIVINGSTON COUNTY DIVIDED BY TOTAL GROSS RECEIPTS MADE OUTSIDE THE COUNTY. 
 
LINE 2:  WAGES, SALARIES, AND OTHER COMPENSATION WITHIN LIVINGSTON COUNTY DIVIDED BY WAGES, SALARIES, AND OTHER 
COMPENSATION WITHIN & WITHOUT LIVINGSTON COUNTY. 
 
LINE 3:  ADD THE PERCENTAGES FROM LINE 1 AND LINE 2 AND DIVIDE THIS PERCENTAGE BY 2. 
 
LINE 4: MULTIPLY THE ENTIRE NET PROFIT ( BOTH IN AND OUTSIDE THE COUNTY) BY PERCENTAGE ON LINE 3. 
 
LINE 5: ENTER 1% OF LINE 4 
 
LINE 6: UP TO 25% PENALTIY OF AMOUNT DUE ON LINE 5, IF NOT MAILED BY DUE DATE.  NOTE:  SEE EXTENSION REQUEST 
 
LINE 7: INTEREST WILL BE ASSESSED AT 1% PER MONTH, 12% PER ANNUM, ON AMOUNT DUE ON LINE 5 IF NOT MAILED BY DUE DATE. 
 
LINE 8: LINE 5 PLUS LINE 6 AND 7(IF APPLICABLE) IS THE AMOUNT DUE WITH RETURN.  PLEASE SIGN AND RETURN YOUR FORM. 
 
KAYLA CURRY 
LIVINGSTON COUNTY TAX ADMINISTRATOR 
TELEPHONE 270-928-3361 
FAX 270-928-3262