PHONE: (270) 842-7168              WARREN COUNTY SCHOOLS                         FAX: (270) 842-3411 
 
                       OCCUPATIONAL LICENSE TAX APPLICATION 
 
                       P.O. Box 51530, 303 Lovers Lane, Bowling Green, KY 42103 
 
MAIL TO:     FINANCE DIRECTOR, 
             WARREN COUNTY SCHOOLS 
             OCCUPATIONAL TAX OFFICE 
             P.O. BOX 51530  
             BOWLING GREEN, KENTUCKY 42102-5830 
 
Type of Entity:                    (  )CORPORATION  (  )LLC  (  )LLP (  )S CORPORATION (  )PLLC 
 
                                   (  )NON PROFIT  (  )PARTNERSHIP  (  )SOLE PROPRIETOR 
 
Federal Empoyer ID #:                                           SSN:              
 
Business Name:  
 
Business Address: 
(Business site &/or local address) 
 
Mailing Address (if different from above): 
 
Nature of Business 
 
Telephone Number:                                 Fax Number:
 
If this is a jobsite please list all locations in Warren County, Kentucky: 
 
Date business first paid, or will pay, wages to employees in Warren County, Kentucky? 
 
                                     Continued on Next Page 

PHONE: (270) 842-7168 WARREN COUNTY SCHOOLS                                    FAX: (270) 842-3411 
             OCCUPATIONAL LICENSE TAX APPLICATION (CONTINUED) 
                      P.O. Box 51530, 303 Lovers Lane, Bowling Green, KY 42103 
 
IF A PARTNERSHIP: List name, address, and social security number of each partner 
IF A CORPORATION: List officers and title  
IF A SOLE PROPRIETOR: List owner name, address, and social security number 
 
PARTNERS/SOLE PROPRIETORS: 
 
Name _____________________________________________  SS#  ___________________________ 
 
Address:     _______________________________________
 
             _______________________________________
 
Name _____________________________________________  SS#  ___________________________ 
 
Address:     _______________________________________
 
             _______________________________________
 
OFFICERS: 
 
Name _____________________________________________  Title  ___________________________ 
 
Name _____________________________________________  Title  ___________________________ 
 
Name _____________________________________________  Title  ___________________________ 
 
Date you assumed ownership  _________________________________________________________ 
 
Accounting Period:    (  ) CALENDAR YEAR 
                      (  ) FISCAL YEAR  Month  __________ Year  _________ 
 
Are you engaged in any other business activity in Warren County, Kentucky?  If so, 
please list: 
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________ 
 
SIGNATURE  _____________________________  TITLE  ___________________  DATE  _________ 
  
PRINT NAME ______________________________________________________________ 
 
EMAIL ADDRESS __________________________________________________________ 
 
  The Warren County School District does not discriminate on the basis of race, color, national origin, sex, religion, age or disability in the employment or 
  the provision of services.  Any and/or all questions or issues related to discrimination policies and procedures are to be directed to the Office of the 
             Superintendent, Warren County Public Schools, 303 Lovers Lane, Bowling Green, Kentucky 42103. Phone (270) 781-5150