OCCUPATIONAL LICENSE TAX WITHHOLDING RETURN 
      Quarter ending:  
          Account #:                                          Due on or before: 
  
 1. Gross Wages and Compensation Paid 
           
 2. Less wages and compensation paid for 
              services outside of Nicholasville 
           
 3. Taxable earnings (line 1 minus line 2) 
 
 4. Current Tax Due (line 3 x 1.5%) 
 
 5. Credit carried forward from previous period 
 
 6. Total Tax Due  
 
 7. Penalty for failure to file a return or pay 
              tax on or before due date:  5% of the total tax 
              due for each calendar month or fraction 
              thereof not to exceed 25% of the total tax due. 
              This penalty shall not be less than $25.00. 
             
 8.  Interest:  12% per annum simple interest on  
              total tax due beginning from the time tax  
              was due.  A fraction of a month counts as 
              an entire month                                              
  
 9.  TOTAL TAX, PENALTY, AND INTEREST DUE 
 
 I hereby certify that this information is true and correct: 
  
 Name________________________________Title_______________________ 
  
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If you have any questions about the occupational license tax or would like a  
Copy of the ordinance you may call the tax office or go to our website at 
www.nicholasville.org 
 
                                                            Make Checks Payable to: City of Nicholasville 
                                                                              and mail along with copy of return to: 
                                                                                               P. O. Box 590 
                                                                                517 North Main Street 
                                                                                Nicholasville, KY 40340-0590 
                                                                          (859) 885-7618    Fax (859) 881-0750