Louisville Metro Revenue Commission                                                                                                                        
                                                                                           
           Occupational License Tax Return                                                                                                                           OL-3 A 
                                                                                                                                                                Form 
                                                                                                                   OL3_A_2017_V1.0 
  
   CHECK IF CHANGE IN ADDRESS IS BELOW 
  
 Last name                                   First name                                    MI                                                                Social Security Number 
                                                                                                                   
 Address (number and street)                                                        Unit/Apt. no.                                                              Account ID 
                                                                                                                   
 City, town or post office                               State                      Zip code                                                                   Tax Year Ending 
                                                                                                                                                                 
 Email                                                   Phone no.                  Ext.                                                                      No Activity 
                                                                                                                                                              Amended Return 
                            Did you make payments in the sum of $600.00 or more to any individual                                                             Final Return 
  YES      NO             for services rendered in Louisville Metro, Kentucky, other than an                                                                Business Cease Date 
                            employee? IF YES, YOU ARE REQUIRED TO FILE FORM 1099-SF.                                                          RETURN STATUS
                                                                                                                                                                       
 Income or   1.             Amount of Net Profit per Federal Schedule C (Attach a copy of Schedule C)            1.                                         $                                             .00 
             2.             Add: Occupational taxes deducted on Federal Schedule C                               2.                                          
 (Loss)                                                                                                                                                     $                                             .00 
             3.             Add lines 1 and 2. This is your Adjusted Net Profit                                                          3.▶                $                                             .00 
 Tax         Do you live in Louisville Metro, Kentucky?                   Yes. Complete Section A only                                      No. Complete Section B only. 
             Section A. Residents of Louisville Metro, Kentucky 
 Computation 4a.            Adjusted Net Profit per Line 3 above                                                 4.                                         $                                             .00 
             5a.            Multiply Line 4, Section A, by (.0220) This is your Tax Due          A               5.                                         $                                             .00 
             6a.            Penalty and Interest (see instructions)                                              6.                                         $                                             .00 
             7a.            Line 5 + Line 6, This is yourAmount Due. ▶                                           7.                                         $                                             .00 
             Section B. Non-Residents of Louisville Metro, Kentucky 
             4b.            Adjusted Net Profit per Line 3 above                                                 4.                                         $                                             .00 
             5b.            Multiply Line 4, Section B, by (.0145) This is yourTax Due           B               5.                                         $                                             .00 
             6b.            Penalty and Interest (see instructions)                                              6.                                         $                                             .00 
             7b.            Line 5 + Line 6, This is yourAmount Due. ▶                                           7.                                         $                                             .00 
 Signature   I hereby certify, under penalty of perjury, that the information provided and the attached supporting schedules are true, 
             correct, and complete to the best of my knowledge. 
             Your signature                                                              Date 
                                                                                          
             Print/Type your name                                   Your title                                   Daytime phone number 
                                                                                                                  
 Preparer    Print/Type preparer’s name                Preparer’s signature               Date                   PTIN 
 Use Only                                                                                                         
             Firm’s name                             ▶                                                           Firm’s EIN    ▶                                
             Firm’s address                         ▶                                                            Phone no. ▶                                    
  
                                                                   IMPORTANT 
   ELECTRONIC FILING: Register for electronic filing. It is an easy, secure, and convenient way to file and pay taxes on-line. For more information log on to 
                                                            https://www.metrorevenue.org. 
                                                                            
   Mail Form OL-3A, along with a copy of Federal Schedule C, and a check or money order with your Account ID. The return and payment of taxes due must be 
                                          received or postmarked by April 15th to avoid penalties and interest. 
  
                                    MAILING ADDRESS: P.O. BOX 35410, LOUISVILLE, KENTUCKY 40232-5410                                                                                                           
                           Telephone: (502) 574-4860  .   Email: taxhelp@metrorevenue.org   .  Fax: (502) 574-4818