WOODFORD COUNTY FISCAL COURT 
                                         103 SOUTH MAIN STREET ROOM 201 
                                         VERSAILLES, KY 40383 
                                         (859) 873-5701   FAX (859) 873-0196 
 Every business or individual subject to the Occupational License Fee is required to complete this application and return it to the Tax Administrator. (OAG-85-1) 
 Kentucky Attorney General states that the Occupational Tax Office must let persons inspect records pertaining to principal business location, address and 
 telephone number of each person or entity(trade name-if different)and nature of business of the person or entity filing the application. Please answer all applicable 
 questions:  
  
 FOR BUSINESS USE ONLY: 
 Name of business or trade name:____________________________________________________________________________________ 
 Business Street Address  
 (Woodford County Address)________________________________________________________________________________________ 
  
 City,State,Zip____________________________________________________________________________________________________ 
  
 Mailing Address__________________________________________________________________________________________________ 
 (To receive quarterly and annual forms) 
  
 City, State,Zip___________________________________________________________________________________________________ 
  
 Telephone number: (______)______________________________________Fax number: (_____)_______________________________ 
 
 Date operations started in Woodford County:_________________________ Approx. Number of  employees____________________ 
  
 Nature of Business:______________________________________________________________________________________________ 
  
 Type of Business:_______Corporation_____S Corporation______Partnership______Individual_____Fiduciary_____Farm 
 ______LLC _____Religious or Non-Profit Organization ______Proprietorship_____Other (Please specify)____________ 
  
 Federal Tax I.D.#_________________Accounting period: ____Calendar year(December 31st) ____Fiscal year (month_____) 
  
 List other business entities in Woodford County______________________________________________________________________ 
  
 List contact person(s)name(s)_______________________________________telephone#______________________________________ 
  
 INDIVIDUAL USE ONLY: (FOR THOSE PERSONS WHOSE EMPLOYER DOES NOT WITHHOLD QUARTERLY TAXES:                                    
 FEDERAL EMPLOYEES INCLUDING UNITED STATES POSTAL SERVICE) 
 Name:_______________________________________________Address___________________________________________________ 
  
 City, State, Zip:_________________________________________________________________________________________________ 
  
 Federal Agency/Business for which you work and address:_____________________________________________________________ 
  
 Start date __________________________________Social Security #___________________________________ 
  
 Telephone number (Agency) (______)_______________________________(Home) (_______)________________________________ 
  
 CONTRACTORS: List All Subcontractors Working under You on this or any Job in Woodford County. 
 PARTNERSHIPS: List All Partners with Address and Social Security Information. (Use additional sheet if necessary) 
  
 Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief, it 
 is true, correct and complete. 
  
 Signature ___________________________________Title______________________________________________Date_____________ 
 FORM:  WCAPP (7/08)