WOODFORD COUNTY TAX ADMINISTRATOR
NET PROFITS LCENSEI FEE RETURN
Name and Address of Business It--_ ''A;::C;:CO=U:---- . . .:. .:NT!...!.!N :::;O:.......,._1. :- ,.--::,C .:.:........=A L=E: :ND::.....:AR/FISCALYEAR. .... . ENDED
MONTH I DAY I YEAR
OFFICE HOURS:
800: 5:- 00 DUE DATE ---,1
MON - FRI
Il...---l I-----.JI
INDICATE ANY NAME OR ADDRESS CHANGE ABOVE (859) 873-5701 Atacht a copy of Federal Tax Return used
as basis of License Fee and 1099's issued
'=="-:-=:=:-:-:C":":"-,-;;"7":"::==,..-;f-------:-------'fo~;r -;-;--;-:-------work--in--Woodfod-{ r County.
QUESTIONS (ANSWER IN FULL)
1.Nature of Business _ 4.Did you have employees in Woodford County? 0Yes 0No
2. Date Business Started in Woodford County _ 5.Basis upon which tax return is prepared DCash 0Accrual
3. If Business was Discontinued, State When _ 6.Business Type: 0c-ccre 0S-Corp 0Partnership 0SoleProp- .
o
Dissolution 0or Sale 0If by sale, give Name and Address of successor Fiduciary 0Other (Specify) _
7. Has the IRS changed the Net Income as originally reported for any
prior year? 0No 0Yes (Attach Schedule of Changes for each year)
SCHEDULE A
ANNUAL PAYROLL 17.ENTER ADJUSTED NET PROFIT (from line 16)
1B. Enert percentage from line 30.
PAYROLL 19. Net Profit Allocation (line 17 x LINE 18)
20. License Fee - 1.5000% ofline 19
-
RATE X 150%. 21. Credits - ( ) Estimated payments or ( ) credit from prior year
22. Balance of license fee due (line 20 minus line 21)
23. Interest - 12~00% per annum or 1% per month
AMOUNT DUE Calcuatel inerestt onamountowed on Inej 20fromoriginal duedate
24. Penalty - 25.00 % MAX; $25 Min; 5% per month
MakeWOODFORDcheckspayableCOUNTYand mailTAXto: • 26.25. IfBALANCEoverpaid IndicateDUE (lneSi ( ) Refund22+23+24)or ( ) Credt i
ADMINISTRATOR
Refundswlli begveni formorethan $5000. . Otherwsei you acrountc willbecredtedi .
103 SOUTH MAIN ST ROOM 201
VERSAILLES KY 40383
Phone Number (859) 873-5701
BUSINESS APPORTIONMENT
APPORTIONMENT FACTORS Woodford Total Everywhere Percent
27. Receipts from the sale, lease, or rental of goods, services or property II 11= = =. =====
28. Payroll Factor (employee compensation) . II 11 _
29. TOTAL PERCENTS :..... ...... .. ....... .................................. .............. ..... ..... ........... . ... ........ ....... ................ I
= ===== == ~
30. AVERAGE PERCENTAGE (Line 29 divided by number of percents) Enert on line 18;Schedule A I
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Ihereby certify,u dern penalty ofperj ryuthatthestatements, made herein a danysupportingn schedules aretrue, corect,r a dcon pletem tothe bestofmyknowledge.
Sgnedi Tilet Date
THIS RETURN IS DUE ON OR BEFORE APRIL 15, FOR THE CALENDAR YEAR OR WITHIN 105 DAYS OF THE END OF YOUR FISCAL YEAR
F RMO WCNP Rev7/14/2008.