CITY OF ST MATTHEWS                                                                        OFFICIAL USE ONLY
PO BOX 7097                                               YEAR
LOUISVILLE KY 40257-0097                                                                   CHECK #
(502)  895-9444
                                BUSINESS LICENSE APPLICATION                               AMOUNT PAID
                                                ANNUAL RENEWAL DUE:  APRIL 30
BUSINESS LICENSE TAX DEPARTMENT                                                            DATE PAID
(502) 899-2515

                 IMPORTANT NOTICE:  READ CAREFULLY BEFORE COMPLETING THIS FORM

BUSINESS/APPLICANT NAME:

BUSINESS ADDRESS:
                                                                City, State, Zip           Telephone Number
MAILING ADDRESS:
                                (If Different From Above)       City, State, Zip           Telephone Number
CONTACT PERSON:
                                                                                           Telephone Number
PRINCIPAL BUSINESS ACTIVITY:

ACCOUNT #                                                       Select the Appropriate Item
                                NEW BUSINESS                    RENEWAL                    FINAL RETURN

                                (Fee = $25.00)                  (See Instructions)
SEE REVERSE SIDE FOR INSTRUCTIONS (for business license renewal)
1)         GROSS RECEIPTS EARNED IN ST. MATTHEWS:
           AS REPORTED BY BUSINESS ON FEDERAL INCOME TAX 
2)         GROSS RECEIPTS TAX TO BE PAID:
           BASED ON TAX TABLE ON REVERSE SIDE 
3)         50 PERCENT DISCOUNT PAYMENT:
           (If Paid By April 30)
4)         PENALTY:
           10% OF LINE 2 IF PAID AFTER APRIL 30 
5)         INTEREST:
           1.5% OF LINE 2 FOR EACH MONTH OR PART THEREOF BEGINNING MAY 1
6)         TOTAL PAYMENT DUE: 

I HEREBY CERTIFY, UNDER PENALTY OF PERJURY, THAT THE STATEMENTS MADE HEREIN AND ANY SUPPORTING
SCHEDULES ARE TRUE, CORRECT AND COMPLETE, TO THE BEST OF MY KNOWLEDGE. 
                                                                                           (Date)

SIGNATURE OF RETURN PREPARER                                    SIGNATURE OF LICENSEE

PRINT NAME                                                      PRINT NAME

TELEPHONE NUMBER                                                    TELEPHONE NUMBER

CITY OF ST. MATTHEWS - BUSINESS LICENSE                                                                            INSTRUCTIONS
DATE DUE:  The St. Matthews Gross Receipts Business License  Application is to be completed and payment submitted on April 
30 of each year in order to renew a business  license.  Payment must be received by April 30  to receive the 50% discount.    
 
PENALTY & INTEREST:  A penalty of 10% of the tax due  will apply if payment is made on or after May 1.  Additionally, interest is 
charged at the rate of 1.5% per month or part thereof.  
 
GENERAL:  Business licenses are required for all businesses located in the City of St. Matthews and/or businesses coming into the 
City to conduct work.  Each separate location is to apply for their individual licensing.  Each business location in the City of St. 
Matthews are to report gross receipts from that location.  Receipts from the sale of alcoholic beverages are not to be computed 
in gross receipts.    
 
The filing fee for the first year of business is $25.   Subsequent renewal fees are based on the gross receipts .  See tax table 
below:  

                                                        TAX TABLE
                      RECEIPTS LESS THAN                $30,000.00  =               $     25.00
                      $30,001.00 or less than           $40,000.00  =               $     30.00
                      $40,001.00 or less than           $50,000.00  =               $     40.00
                      $50,001.00 or less than           $60,000.00  =               $     50.00
                      $60,001.00 or less than           $70,000.00  =               $     60.00
                      $70,001.00 or less than           $80,000.00  =               $     70.00
                      $80,001.00 or less than           $90,000.00  =               $     80.00
                      $90,001 or less than              $100,000.00 =               $     90.00

All receipts in excess of $100,000.00 are to be taxed at the rate of fifty cents (.50) for each $1,000 or fraction 
thereof.  See Example Below.  (Subtract $100,000.  Multiply by .0005.  Add $90.00)

              Receipts of $100,001 or more:             $150,000.00 =               $  115.00
                      ($150,000 - $100,000 = $50,000 x .0005 = 25.00 + $90)

PAYMENTS:   We cannot accept credit card payments at this time.   Please send payment by check, made payable to the City of 
St. Matthews.   Mail to the City of St. Matthews, Business License Department, PO Box 7097, Louisville KY 40257-0097.  
 
QUESTIONS:  Please contact the City of St. Matthews Business License Department (502 -899-2515) during normal business 
hours of 7:30 AM to 4:00 PM, Monday through Thursday,  7:30 AM to 11:30 AM Friday.   City Hall address - 3940 Grandview 
Avenue, Louisville  KY 40207 (502 895-9444).   
 
OTHER TAXES:  The City of St. Matthews has an Occupational Employee Withholding Tax , Professional License Tax, and Real 
Estate Tax, in addition to the Gross Receipts Tax.   If any additional information is needed , please call the appropriate clerk.  
 
YOUR BUSINESS LICENSE WILL BE ISSUED UNDER THE PROVISIONS OF THE CITY OF ST. MATTHEWS CODE CHAPTER 110.  YOU 
ARE CAUTIONED THAT THE LICENSE DOES NOT PERMIT OPERATION OF A BUSINESS IN VIOLATION OF OTHER  MUNICIPAL CODE 
SECTIONS.  YOUR BUSINESS LOCATION WILL BE CHECKED BY ZONING AND, IF NECESSARY, FIRE DEPARTMENT OFFICIALS.  IF YOU 
HAVE ANY DOUBT THAT YOUR BUSINESS LOCATION CONFORMS WITH THE REQUIREMENTS OF THE MUNICPAL CODE 
ADMINISTERED BY THESE DEPARTMENTS, YOU ARE URGED TO CONTACT THESE DEPARTMENTS FOR FURTHER INFORMATION  
BEFORE FILING THIS APPLICATION FOR A BUSINESS LICENSE.  LICENSE FEES ARE NON-REFUNDABLE. 
 
THE BUSINESS LICENSE DEPARTMENT IS TO BE NOTIFIED IMMEDIATEL Y IF YOUR BUSINESS MOVES FROM THE  CITY, HAS A 
CHANGE OF OWNERSHIP, NAME CHANGE OR CHANGE OF ADDRESS.  
 

          RETURN TO THE ATTENTION OF BUSINESS LICENSE/OCCUPATIONAL TAX 
BL2. REV. 
10/2013   P.O. BOX 7097
          ST. MATTHEWS, KENTUCKY 40257-0097