Louisville Metro Revenue Commission 

          Occupational License Tax Return 
                                                                                                          OL-EZ_2018_V1.0           Form 
                                                                                                                                         OL-3 EZ 

 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
                                                                                                                          Final Return
                                                                                                                           BUSINESS CEASE DATE                
                                                                                                           RETURN STATUS

Income or   1.            Amount of income per Federal Form 1099-MISC (Attach a copy of Form 1099       1.               $                       .00 
                          or page 1 of 1040 reflecting other income reported) 
(Loss)      2.            Gross salaries, wages, tips, etc. reported on Federal Form W-2 where the full 2.               $                       .00 
                          amount of occupational taxes were not withheld, plus deferred 
                          compensation from 401 (K)/403 (B)/457 plans(Attach  a copy of Form W-2) 
            3.            Add lines 1 and 2. This is your total income                            ▶     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.           Multiply Line 3 by (.0220). This is your Tax Due .                            4.               $                       .00 
            5a.           Penalty and Interest (see instructions)                         A             5.               $                        .00 
            6a.           Add lines 4 and 5. This is your Amount Due. ▶                                 6.               $                       .00 
            Section B. Non-Residents of Louisville Metro, Kentucky 
            4b.           Multiply Line 3 by (.0145). This is your Tax Due.                             4.               $                       .00 
            5b.           Penalty and Interest (see instructions)                         B             5.               $                       .00 
            6b.           Add lines 4 and 5. This is your Amount Due. ▶                                 6.               $                        .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-3EZ, along with a copy of Form 1099-MISC, Form W-2, or page 1 of Form 1040, and a check or money order with your Account Id number. 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