SPENCER COUNTY, KENTUCKY NET PROFIT LICENSE FEE RETURN         For Year Ending  Business Type                   Account # 
                                                              (m/d/y) 
Occupational License Administrator                                              Individual 
                                                                                Corporation                     Federal ID or SSN 
                                                                                                            
Taylorsville, KY  40071                                                                                         Amended 
P.O. Box 397                       Accounting Method                            Partnership                                       No Business Activity 
                                           ?                                                                        ?
www.spencercountyky.gov            Cash                                                                         No 
(502) 477-2997   (502) 477-2998    Accrual ?                  Due Date          Other                           Yes ?             Yes                                 
                                                                                                                            
Make Check payable to:  Spencer County Treasurer.                               Final (list date operations ceased) 
Online payments:  www.spencercountyky.gov, choose work here, Occ Tax Forms 
 
Name: ____________________________________________________________________________________________ 
Address: ___________________________________________________________________________________________ 
City: ______________________________State: ________Zip: _________ Email:_________________________________ 
Phone: _______________________________Fax:___________________________ 

Each filing individual/entity MUST include copies of all business tax documents filed with IRS.  Individuals:  Schedule 
C/E/1099; Partnership:  1065/8825; Corporation:  1120/1120A/1120S/8825.  All entities must file supporting 
schedules for deductions.  If payments were made to any individual/business for rent, services rendered, repairs, etc. 
you must provide the name, address and amount paid. 
Principal Business Activity: ____________________________________________________________________________ 
Date business began: ___________Did you file a consolidated return??______ (If yes, see Net Profit License Fee Instructions) 
During the past year, did Federal Authorities change or propose to change net income reported for that year or any prior 
year? ________?      Which year(s)__________(Attach statement if yes) 
Was there a change in ownership in the past year??_______Date ____________New Owner: ______________________ 
If business activity was discontinued within this locality during the year, please state when and the reason: 
_________________________________________________________________________________________________ 
List Principal Administrative Officer Name, Address & SSN: 
__________________________________________________________________________________________________ 
 24. Adjusted Net business income from line 19                                                 ___________________ $0.00
 25. Apportionment percentage from line 23         (enter as a decimal)                            ___________________ 0
 26. Net Profit subject to license fee (line 24 x line 25)                                                 $0.00__________________ 
 27. License Fee Due (  0.80% x line 26 - Minimum License Fee $25.00)                         ___________________ $0.00
 28. Late fee 5% per month (max not to exceed 25%/minimum $25)                                 ___________________ $0.00
 29. Interest fee 1% per month (12% per year) fraction of month = 1 month                      ___________________ $0.00
 30. Net profit license fee due Spencer County (Sum of lines 27,28, 29)                        ___________________ $0.00
 31. If you purchased a Spencer County Business License for 201 /2018           9
       Deduct $25.00 from amount due.  License #________ or Estimated Pmt.       ___________________  
 32.  Subtotal (Sum of lines 30 & 31)                                                                   0.00
                                                                                                                                                ___________________  
        
 33 . Spencer    County Business License Fee for     201 /209 20, add $25                          ___________________ $0.00
 34 . Total amount due Spencer County (Sum of lines 32,33)                                              ___________________ $0.00

 __________________________________________________    ____________________________________________  
Preparer’s Signature                                                    Signature of Licensee 
 __________________________________________________    ____________________________________________  
Print Name                                                              Print Name & Title 
 __________________________________________________    ____________________________________________  
Address                                                                 Address 
 __________________________________________________    ____________________________________________  
City, State, Zip                                                        City, State, Zip 
 __________________________________________________    ____________________________________________  
Date, Fed. ID, Phone                                                    Date, Federal ID 

Spencer County Net Profit License Fee Return           Revised 12/2017                                                       

 ADJUSTED NET PROFIT CALCULATION                                                                                       INDIVIDUAL   PARTNERSHIP   CORPORATION 
      1)Non-employee compensation reported as "other income" on                                                                                                 
 Federal 1040 (Attach Page 1 of Form 1040 and Form 1099 if 
 applicable)                                                                                                                        
      2)Net profit per each Federal Schedule C and/or E (If reporting more 
 than one schedule, each schedule must be reported separately)                                                                      
   3)  Capital gain from Federal Form 4797 or Federal Form 6252 
 reported on Schedule D of Form 1040 (Attach Form 4797, Pages 1 and 
 2 or Form 6252)                                                                                                                    
  4)  Ordinary gain or (loss) on the sale of property used a trade or 
 business per Federal Form 4797  (Attach Form 4797, pages 1 and 2)                                                                  
      5)Ordinary income or (loss) per Federal Form 1065 (Attach Form                                                                                            
 1065, Pages 1, 2 and 3, Schedule of Other Deductions, and Rental 
 Schedule(s), if applicable)                                                                                                                      
                                                                                                                                                  
      6)Taxable income or (loss) per Federal Form 1120 or 1120A or 
 Ordinary income or (loss) per Federal Form 1120S (Attach Form 1120/ 
 1120A, Pages 1 & 2; 1120S, Pages 1-3, and Schedule of other 
 Deductions, and Rental Schedule(s) if applicable.)                                                                                                             
   7) Add state/local license fees or state income taxes and occupational 
 license taxes based upon income deducted on the Federal Schedule C 
 or E or Form 1065, 1120, 1120A or 1120S                                                                                                                        
      8)Additions from Schedule K of Form 1065 or Form 1120S (Attach 
 Schedule K of Form 1065 or 1120S and Rental Schedule(s), if 
 applicable)                                                                                                                                                    
                                                                                                                                   
   9)  Add net operating loss deducted on Form 1120/1120REIT                                                                                                    
                                                                                                                                                 
 10)  Pass through loss from another entity included on Federal Form                                                                                            
                                                                                      $0.00                                         $0.00         $0.00
 11)  Total Income - Add Line 1 through Line 10                                                                                                                 
 12)  Subtractions from Schedule K of Form 1065 or Form 1120S                                                                      
 (Attach Schedule K of Form 1065 or 1120S and Rental Schedule(s), if 
 applicable)                                                                                                                                                    
                                                                                                                                   
 13)  Alcoholic Beverage Sales Deduction                                                                                                                        

 14) Pass thru profit from another entity included on Federal Return 
                                                                                                                                                               
 15)  Other Adjustments (Attach Schedule)                                                                                                                       
                                                                                                                                   
 16) Non-taxable income (see instructions for details) 
         Professional expenses not reimbursed by the Partnership (Attach                                                                                       
 17) 
 Schedule of Expenses) 
                                                                                                                                                               
                                                                                      $0.00                                         $0.00         $0.00
 18)  Total Deductions - Add Line 12 through Line 17 
 19) 
         Adjusted Net Profit - Subtract Line 18 from Line 11.  Enter here             $0.00                                         $0.00         $0.00        
 and on Line 24 on the front page. 
                                                                                                                                                               
                                                            WORKSHEET Y:  BUSINESS APPORTIONMENT 
            APPORTIONMENT                          COLUMN A                           COLUMN B                                            DIVIDE (A / B = C) 
                FACTORS                             SPENCER                     TOTAL EVERYWHERE 
 20) PAYROLL FACTOR                                                                                                                 0.00%
 Compensation paid during the year to employees                                                                                     
 21) SALES REVENUE FACTOR                                                                                                                                      
 Receipts from the sale, lease or rental of goods,                                                                                  0.00%
 services or property                                                                                                               
                                                                                                                                                               
 22) TOTAL PERCENTAGES                                                                                                              0.00%
 23) BUSINESS APPORTIONMENT - ENTER                HERE AND ON LINE 2 5 OF NET PROFIT LICENSE FEE RETURN                                                       
 If you had both a payroll factor and a sales revenue factor, then divide line 22 by two (2) and enter the number on line 23        0.0%
  If you had a payroll factor or sales revenue factor, but not both, then enter the percentage from line 22 on line 23 
                                                                                                                                     
Spencer County Net Profit License Fee Return 12/2017