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                                               CITY OF OWENSBORO AND DAVIESS COUNTY FISCAL COURT 
                                        AMENDED NET PROFIT LICENSE FEE RETURN 
 
Business Name                                                        Account Number       Business Classification: (Check one) 
                                                                                          ( ) Corporation       ( ) Partnership 
                                                                                          ( ) Individual  ( ) Fiduciary  ( ) Other 
Business Address                                                                           
                                                                                          Business Telephone____________________ 
                                                                                           
                                                                     Period Ending        Soc. Sec. # and/or Fed. ID #: 
                                                                                                   
PART I                                                                                I                       II                                 III  
                                                                      As Originally                           Net Change            
LICENSE FEE DUE                                                      Reported or Adjusted                     Increase or Decrease      Correct Amount 
     TOTAL NET PROFIT FROM WORKSHEET:                                                                                               
       1A. City of Owensboro……….................................... 
                                                                                                                                    
       1B. Daviess County………………………………… 
     PRE-APPORTIONMENT ADJUSTMENTS:                                                                                                     
       2A. City of Owensboro………………………………                                                                                                        
                                                                                                                                    
       2B. Daviess County………………………………… 
     ADJUSTED NET PROFIT:                                                                                                           
       3A. City of Owensboro (line 1A plus line 2A)……… 
                                                                                                                                    
       3B. Daviess County (line 1B plus line 2B)………….. 
      BUSINESS APPORTIONMENT: (Worksheet Y)                                                                                         
       4A. City of Owensboro……………………………… 
                                                                                                                                    
       4B. Daviess County………………………………… 
     TAXABLE NET PROFIT:                                                                                                            
        5A. City of Owensboro (line 3A X line 4A)………... 
                                                                                                                                    
        5B. Daviess County (line 3B X line 4B)…………….  
     LICENSE FEE DUE:                                                                                                               
        6A. City of Owensboro (1.33% of line 5A)…............ 
                                                                                                                                    
        6B. Daviess County (Applicable Rate from Table A     
             or Table B of instructions multiplied by line 5B).. 
      PENALTY: (5% per calendar month not to exceed                                                                                 
                             25%, $25 Minimum) 
        7A. City of Owensboro……………………………... 
                                                                                                                                    
        7B. Daviess County…………………………………. 
     INTEREST: (1% per calendar month or fraction                                                                                   
                              thereof) 
        8A. City of Owensboro…………………………….. 
                                                                                                                                    
        8B. Daviess County………………………………… 
     TOTAL AMOUNT DUE:                                                                                                              
        9A. City of Owensboro (Add lines 6A, 7A and 8A)... 
                                                                                                                                    
        9B. Daviess County (Add lines 6B, 7B and 8B)…….  
CONTINUED ON BACK

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PAYMENTS AND CREDITS

LICENSE FEE, INTEREST AND PENALTY PAID WITH ORIGINAL RETURN
10A. City of Owensboro…………………………………………………………………………………..

10B. Daviess County………………………………………………………………………………………
PAYMENTS OR CREDITS NOT CLAIMED ON THE ORIGINAL RETURN:
11A. City of Owensboro…………………………………………………………………………………...

11B. Daviess County……………………………………………………………………………………….
TOTAL PAYMENTS AND CREDITS:
12A. City of Owensboro (line 10A plus line 11A)………………………………………………………...

12B. Daviess County (line 10B plus line 11B)…………………………………………………………….

REFUND OR AMOUNT DUE

REFUND OR CREDIT, IF ANY, SHOWN ON ORIGINAL RETURN:
13A. City of Owensboro…………………………………………………………………………………..

13B. Daviess County………………………………………………………………………………………
TOTAL ADJUSTED CREDITS:
14A. City of Owensboro (line 12A minus line 13A)……………………………………………………...

14B. Daviess County (line 12B minus line 13B)………………………………………………………….
TOTAL AMOUNT DUE:
15A. City of Owensboro: If line 9A of Column III is more than line 14A, enter the amount due……...

15B. Daviess County: If line 9B of Column III is more than line 14B, enter the amount due…………...
TOTAL REFUND DUE:
16A. City of Owensboro: If line 9A of Column III is less than line 14A, enter the refund due………...

16B. Daviess County: If line 9B of Column III is less than line 14B, enter the refund due…………….

PART II

Give a brief explanation why this amended return is being filed. Attach a copy of the amended Federal return or schedule
as applicable.

I, the undersigned, declare under penalties of perjury that I have examined this return, including all accompanying schedules and statements,
and to the best of my knowledge and belief it is true, correct and complete.

_______________________________________ ______________________ _____________________________________________
Signature and Phone Number of Preparer Date Signature of License Fee Payer

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INSTRUCTIONS

PART I

Line 1A City of Owensboro
Column I - Enter the total net profit as originally reported on Worksheet C, I, or P.
Column III - Enter the amended total net profit as corrected from the amended Worksheet C, I, or P.
Column II – Enter the net increase or decrease of Total Net Profit.

Line 1B Daviess County
Column I - Enter the total net profit as originally reported on Worksheet C, I, or P.
Column III - Enter the amended total net profit as corrected from the amended Worksheet C, I, or P.
Column II – Enter the net increase or decrease of Total Net Profit.

Line 2A City of Owensboro
Column I - Enter the total net profit or loss, as originally reported or adjusted, resulting from: real estate rental if the Gross
Receipts from such rental is $5,000 or less for periods ending on or after 12/31/06, or for the rental of less than 10 single
habitable residential units if period ending is prior to 12/31/06; the sale of farm products by a farmer in the city limits,
as defined by regulation; and amounts earned prior to attaining age 16. If the amount is a net profit, enter as a
negative number. If the amount is a net loss, enter as a positive number. Attach Schedule showing exempt amounts.
Column III - Enter the corrected total net profit or loss resulting from: real estate rental if the Gross Receipts from such rental is
$5,000 or less for periods ending on or after 12/31/06, or for the rental of less than 10 single habitable units if period ending is prior
to 12/31/06; the sale of farm products by a farmer in the city limits, as defined by regulation; and amounts earned prior to attaining
age 16. If the amount is a net profit, enter as a negative number. If the amount is a net loss, enter as a positive number. Attach
Schedule showing exempt amounts. Column II – Enter the net increase or decrease in Pre-Apportionment Adjustments.

Line 2B Daviess County
Column I – Enter the total net profit or loss, as originally reported or adjusted, resulting from: the rental of less than 10 single
habitable residential rental units in Daviess County, outside the city limits of Owensboro; and amounts earned prior to attaining
age 16. If the amount is a net profit, enter as a negative number. If the amount is a net loss, enter as a positive number. Attach
Schedule showing exempt amounts.
Column III -Enter the corrected net profit or loss, as originally reported or adjusted, resulting from: the rental of less than 10
single habitable residential units in Daviess County, outside the city limits of Owensboro; and amounts earned prior to attaining
age 16. If the amount is a net profit, enter as a negative number. If the amount is a net loss, enter as a positive number.
Attach Schedule showing exempt amounts.
Column II – Enter the net increase or decrease in Pre-Apportionment Adjustments.

Line 3A City of Owensboro
Column I - Enter the Adjusted Net Profit as originally reported or adjusted. Line 1A plus Line 2A.
Column III - Enter the Adjusted Net Profit as amended. Line 1A plus Line 2A
Column II - Enter the net increase or decrease to Adjusted Net Profit.

Line 3B Daviess County
Column I - Enter the Adjusted Net Profit as originally reported or adjusted. Line 1B plus Line 2B.
Column III - Enter the Adjusted Net Profit as amended. Line 1B plus Line 2B
Column II - Enter the net increase or decrease to Adjusted Net Profit.

Line 4A City of Owensboro
Column I - Enter the Business Apportionment Percentage as originally reported or adjusted.
Column III - Enter the Business Apportionment Percentage as amended.
Column II - Enter the net increase or decrease to the Business Apportionment Percentage.

Line 4B Daviess County
Column I - Enter the Business Apportionment Percentage as originally reported or adjusted.
Column III - Enter the Business Apportionment Percentage as amended.
Column II - Enter the net increase or decrease to the Business Apportionment Percentage.

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Line 5A  City of Owensboro 
         Column I - Enter the                 Taxable Net Profit                 as originally reported or adjusted.Multiply Line 3A by Line 4A.  
               Column III - Enter the corrected Taxable Net Profit.                    Multiply Line 3A by Line 4A. 
               Column II - Enter the net increase or decrease of Taxable Net Profit. 
 
Line 5B  Daviess County 
         Column I - Enter the                 Taxable Net Profit                 as originally reported or adjusted.Multiply Line 3B by Line 4B.  
               Column III - Enter the corrected Taxable Net Profit.                    Multiply Line 3B by Line 4B. 
               Column II - Enter the net increase or decrease of Taxable Net Profit. 
 
Line 6A  City of Owensboro  
         Column I - Enter 1.33% of Line 5A as originally reported or adjusted. 
               Column III - Enter 1.33% of Line 5A as amended. 
               Column II - Enter the net increase or decrease of License Fee Due. 
  
Line 6B Daviess County  
         Column I - Multiply the applicable rate from Table A or Table B below by line 5B as originally reported or adjusted. 
         Column III - Multiply the applicable rate from Table A or Table B below by line 5B as amended. 
               Column II - Enter the net increase or decrease of License Fee Due.  
                
                                              Table A                                                                                                 Table B                                                 
 
                      Period Ending                        Rate (%)                                              Period Ending                   Rate(%)          
                      (tax year end)                                                                                       (tax year end)                                                                            
 
                                                                       07/31/05  .0417                             01/31/07                                  .4875 
                                                                       08/31/05  .0833                             02/28/07                                  .4750 
                      09/30/05                                                   .1250                             03/31/07                                  .4625 
                      10/31/05                                                   .1667                             04/30/07                                  .4500 
 
                      11/30/05                                                   .2084                             05/31/07                                  .4375 
                      12/31/05                                                   .2500                             06/30/07                                  .4250 
                      01/31/06                                                   .2917                             07/31/07                                  .4125 
                      02/28/06                                                   .3333                             08/31/07                                  .4000 
                      03/31/06                                                   .3750                             09/30/07                                  .3875 
                      04/30/06                                                   .4167                             10/31/07                                  .3750 
                      05/31/06                                                   .4584                             11/30/07                                  .3625 
               06/30/06 thru 12/31/06                                            .5000                     12/31/07 and after                                .3500 
 
Line 7A  City of Owensboro 
         Column I – Enter penalty as originally reported.  Any licensee who fails to file and/or pay the license fee by the due date  
         shall pay penalty at the rate of 5% per calendar month, not to exceed 25% of the total license fee due,                                                    
         however, the penalty will always be a minimum of $25. Multiply applicable percentage by Line 6A. 
         Column III – Enter penalty due on the amended license fee due.  Any licensee who fails to file and/or pay the license fee by  
         the due date shall pay penalty at the rate of 5% per calendar month, not to exceed 25% of the total license                                                
         fee due, however, the penalty will always be a minimum of $25. Multiply applicable percentage by Line 6A. 
         Column II – Enter the net increase or decrease of penalty. 
 
Line 7B  Daviess County 
         Column I – Enter penalty as originally reported.  Any licensee who fails to file and/or pay the license fee by the due date  
         shall pay penalty at the rate of 5% per calendar month, not to exceed 25% of the total license fee due,                                                    
         however, the penalty will always be a minimum of $25. Multiply applicable percentage by Line 6B. 
         Column III – Enter penalty due on the amended license fee due. Any licensee who fails to file and/or pay the license fee by  
         the due date shall pay penalty at the rate of 5% per calendar month, not to exceed 25% of the total license                                                
         fee due, however, the penalty will always be a minimum of $25. Multiply applicable percentage by Line 6B. 
         Column II – Enter the net increase or decrease of penalty.

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Line 8A City of Owensboro
Column I – Enter interest as originally reported. Any licensee who fails to pay the license fee by the due date shall pay
interest at the rate of 1% per calendar month, or fraction thereof, of any license fee due. Multiply Line 6A by
applicable percentage.
Column III – Enter interest due on the amended license fee due. Any licensee who fails to pay the license fee by the due date
shall pay interest at the rate of 1% per calendar month, or fraction thereof, of any license fee due. Multiply
Line 6A by applicable percentage.
Column II – Enter the net increase or decrease of interest.

Line 8B Daviess County
Column I – Enter interest as originally reported. Any licensee who fails to pay the license fee by the due date shall pay
interest at the rate of 1% per calendar month, or fraction thereof, of any license fee due. Multiply Line 6B by
applicable percentage.
Column III – Enter interest due on the amended license fee due. Any licensee who fails to pay the license fee by the due date
shall pay interest at the rate of 1% per calendar month, or fraction thereof, of any license fee due. Multiply
Line 6B by applicable percentage.
Column II – Enter the net increase or decrease of interest.

Line 9A City of Owensboro
Column I – Enter total amount due as originally reported. Add Lines 6A, 7A and 8A.
Column III – Enter total amount due as amended. Add Lines 6A, 7A and 8A.
Column II – Enter the net increase or decrease of the total amount due.

Line 9B Daviess County
Column I – Enter total amount due as originally reported. Add Lines 6B, 7B and 8B.
Column III – Enter total amount due as amended. Add Lines 6B, 7B and 8B.
Column II – Enter the net increase or decrease of the total amount due.

Line 10A City of Owensboro - Enter the amount of license fee, interest and penalty paid with original return.

Line 10B Daviess County - Enter the amount of license fee, interest and penalty paid with original return.

Line 11A City of Owensboro - Enter any existing payments or credits not claimed on the original return.

Line 11B Daviess County - Enter any existing payments or credits not claimed on the original return.

Line 12A City of Owensboro - Enter total payments and credits. Line 10A plus Line 11A.

Line 12B Daviess County - Enter total payments and credits. Line 10B plus Line 11B.

Line 13A City of Owensboro – Enter refund or credit, if any, shown on original return.

Line 13B Daviess County - Enter refund or credit, if any, shown on original return.

Line 14A City of Owensboro – Enter adjusted credits. Line 12A minus Line 13A.

Line 14B Daviess County – Enter adjusted credits. Line 12B minus Line 13B.

Line 15A City of Owensboro - If Line 9A of Column III is more than Line 14A, enter the amount due. Any overpayment of license fee to
the City of Owensboro, including payments made with an extension request, will not be allowed to offset any
underpayment of license fee to Daviess County. Any overpayment of license fee to Daviess County, including payments made
with an extension request, will not be allowed to offset any underpayment of license fee to the City Of Owensboro.

Line 15B Daviess County - If Line 9B of Column III is more than Line 14B, enter the amount due. Any overpayment of license fee to
the City of Owensboro, including payments made with an extension request, will not be allowed to offset any
underpayment of license fee to Daviess County. Any overpayment of license fee to Daviess County, including payments made
with an extension request, will not be allowed to offset any underpayment of license fee to the City Of Owensboro.

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Line 16A        City of Owensboro – If Line 9A of Column III is less than Line 14A, enter the refund due. Any overpayment of license fee to 
  the City of Owensboro, including payments made with an extension request, will not be allowed to offset an   
  underpayment of license fee to Daviess County. Any overpayment of license fee to Daviess County, including payments made 
  with an extension request, will not be allowed to offset any underpayment of license fee to the City Of Owensboro. 
                No refund is issued under $5.   
 
Line 16B Daviess County - – If Line 9B of Column III is less than Line 14B, enter the refund due. Any overpayment of license fee to 
   the City of Owensboro, including payments made with an extension request, will not be allowed to offset any  
   underpayment of license fee to Daviess County. Any overpayment of license fee to Daviess County, including payments made 
   with an extension request, will not be allowed to offset any underpayment of license fee to the City Of Owensboro. 
                 No refund is issued under $5. 
 
PART II 
 
Give a brief explanation why the amended return is being filed. Attach a copy of corrected Worksheet C, I or P and/or the amended federal 
return or schedule as applicable. 
 
Mail to:  Occupational Tax Administrator 
                PO Box 10008 
                Owensboro, KY  42302-9008 
                Telephone Number:  (270) 687-5600 
                    www.owensboro.org

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