COMMONWEALTH OF KENTUCKY
   DEPARTMENT OF REVENUE
FRANKFORT, KENTUCKY  40620
   73A801(P)

                        2016 KENTUCKY BANK FRANCHISE TAX
                               FORMS AND INSTRUCTIONS

                                Bank Franchise Tax Return (Form 73A801)
                                                 
                          Application for 90-Day Extension of Time to File (Form 73A802)
                        Kentucky Registration Application for Bank Franchise Tax (Form 73A800)

   RTN (BANK FRANCHISE TAX ACCOUNT NUMBER)
   The routing and transit number (RTN) will be the financial institution's bank franchise tax account number. This number 
   must be listed in the appropriate spaces on each applicable form.

PURPOSE OF THE FORMS PACKET                                 c.  any corporation organized under the provisions of 12 
                                                                    U.S.C. secs. 611 to 631, in effect on December 31, 1997, 
This packet has been designed for financial institutions,           exclusive of any amendments made subsequent to 
both domestic and foreign, which are required by law to             that date, or any corporation organized after Decem-
file the Bank Franchise Tax Return, Revenue Form 73A801.            ber 31, 1997, that meets the requirements of 12 U.S.C. 
It contains the forms and schedules needed by most                  secs. 611 to 631, in effect on December 31, 1997; or
financial institutions. 
                                                            d.  any agency or branch of a foreign depository as 
WHO MUST FILE                                                       defined in 12 U.S.C. sec. 3101, in effect on December 
                                                                    31, 1997, exclusive of any amendments made 
Every financial institution regularly engaged in business           subsequent to that date, or any agency or branch of 
in Kentucky at any time during the taxable year must                a foreign depository established after December 31, 
file Form 73A801. A financial institution is presumed to            1997, that meets the requirements of 12 U.S.C. sec. 
be regularly engaging in business in Kentucky if during             3101 in effect on December 31, 1997.
any taxable year it obtains or solicits business with 20 or 
more persons within Kentucky, or if receipts attributable   Each financial institution engaging in business in 
to sources in Kentucky equal or exceed $100,000.            Kentucky should obtain and complete a Kentucky 
                                                            Registration Application for Bank Franchise Tax, Form 
"Financial institution" means:                              73A800. Copies of the application are available by 
                                                            accessing the Kentucky Department of Revenue’s Web 
a. a national bank organized as a body corporate and        site at www.revenue.ky.gov, or by requesting a copy of 
   existing or in the process of organizing as a national   the form from the taxpayer service centers throughout 
   bank association pursuant to the provisions of the       Kentucky or from the Miscellaneous Tax Branch, 
   National Bank Act, 12 U.S.C. sec. 21 et seq., in effect  Department of Revenue, P.O. Box 1303, Frankfort, KY 
   on December 31, 1997, exclusive of any amendments        40602-1303.
   made subsequent to that date;
                                                            The bank franchise tax is in lieu of all city, county and 
b.  any bank or trust company incorporated or organized     local taxes, except the real estate transfer tax levied in 
   under the laws of any state, except a banker’s bank      KRS Chapter 142, real property and tangible personal 
   organized under KRS 287.135;                             property taxes levied in KRS Chapter 132, the local 

franchise tax levied in KRS 136.575 and taxes upon users         The tax credit amount that may be claimed by an investor 
of utility services. Every financial institution regularly       in any tax year shall not exceed 50 percent of the initial 
engaged in business in Kentucky will be subject to all           aggregate credit amount approved by the authority for the 
state taxes except the corporation income tax levied in          investment fund which would be proportionally available 
KRS Chapter 141 and the corporation license tax levied           to the investor. Example: An investor with a 10 percent 
in KRS Chapter 136.                                              investment in a fund which has been approved for a 
                                                                 total credit to all investors of $400,000 would be limited 
Any financial institution subject to the annual franchise        to $20,000 maximum credit in any given year ($400,000 
tax that fails to file a return or that fails to pay the tax as  x 10% x 50%).
listed on the return shall not maintain an action, suit, or 
proceeding in any court or before any agency in Kentucky         If the amount of credit that may be claimed in any tax year 
or enforce in any way any obligation of any debts until the      exceeds the financial institution’s tax liability, the excess 
return is filed and the tax listed on the return is paid.        credit may be carried forward, but the carry-forward of 
The president, vice president, secretary, treasurer or any       any excess tax credit shall not increase the limitation that 
other person holding any equivalent corporate office of          may be claimed in any tax year. Any credit not used in 
any financial institution subject to the bank franchise          15 years, including the year in which the credit may first 
tax will be personally and individually liable, jointly and      be claimed, shall be lost. If you claim a credit forward, 
severally, in the event that the financial  institution is un-   attach a schedule explaining how the credit forward was 
able to make payment. Neither the corporate dissolution          calculated.
or withdrawal of the financial institution from Kentucky 
nor the cessation of holding any corporate office will dis-      Information regarding the approval process for this 
charge the liability. The personal and individual liability      credit may be obtained from the Cabinet for Economic 
will apply to each and every person holding a corporate          Development, Department of Financial Incentives at (502) 
office at the time the taxes become or became due. No            564-4554.
person will be personally and individually liable if that 
person did not have authority in the management of the           KENTUCKY HISTORIC PRESERVATION TAX CREDIT—The 
business or financial affairs of the financial institution at    2005 Kentucky General Assembly created the Kentucky 
the time the taxes become or became due.                         Historic Preservation Tax Credit. This credit is available 
                                                                 for buildings listed in the National Register of Historic 
ITEMS OF SPECIAL INTEREST                                        Places or located within a historic district listed in the 
                                                                 National Register and certified by the Kentucky Heritage 
INTERNAL REVENUE CODE REFERENCE DATE—Unless                      Council as contributing to the historic significance of the 
specified otherwise, references to the "Internal Revenue         National Register district. This credit is administered by 
Code" for bank franchise tax purposes mean the Internal          the Kentucky Heritage Council. To claim the credit, a copy 
Revenue Code (IRC) in effect on December 31, 2001,               of the notification from the Kentucky Heritage Council 
exclusive of any amendments made subsequent to that              reflecting the amount of credit granted and the year in 
date.                                                            which the credit may first be claimed must be attached 
                                                                 to the return. 
AMENDED RETURNS—An amended bank franchise 
tax return may be filed by completing Form 73A801 
and checking the box denoting Amended Return in the              Per KRS 171.397(8), this credit may be transferred to a 
address section of the form. An amended return may               financial institution that is subject to the Kentucky bank 
be necessary to correct Form 73A801 as originally filed          franchise tax. Within 30 days of such a transfer, the 
or as later adjusted by an amended return, claim for             Department of Revenue must be notified of the name, 
refund, etc.                                                     address, employer identification number, bank routing 
                                                                 and transfer number of the party to which the credit is 
KENTUCKY INVESTMENT FUND ACT CREDIT—The                          transferred, and the amount of the transfer. Additional 
2002 Kentucky General Assembly amended the Kentucky              information may also be required at the Department of 
Investment Fund Act (KIFA) so that the KIFA tax credit           Revenue’s request.
may now be applied against the bank franchise tax. A 
financial institution that makes a cash contribution to an       If the amount of credit that may be claimed in any tax 
investment fund approved by the Kentucky Economic                year exceeds the financial institution’s tax liability, the 
Development Finance Authority (KEDFA) in accordance              excess credit may be carried forward. Any credit not used 
with KRS 154.20-250 to 154.20-284 is entitled to a non-          in seven years, including the year in which the credit may 
refundable credit equal to 40 percent of the investor’s          first be claimed, shall be lost. If you claim a credit forward, 
proportional ownership share of all qualified investments        attach a schedule explaining how the credit forward was 
made by its investment fund and verified by the authority.       calculated.
To claim the credit a copy of the notification from KEDFA 
reflecting the amount of credit granted and the year in          Information regarding the approval process for this credit 
which the credit may first be claimed must be attached           may be obtained from the Kentucky Heritage Council at 
to the return.                                                   (502) 564-7005.

                                                                2

GENERAL INFORMATION                                          ELECTRONIC FUNDS TRANSFER (EFT) REFUNDS—EFT 
                                                             refunds are available if payment is made by EFT.
REQUIRED FORMS AND INFORMATION—Each financial 
institution must enter all applicable information on Form    PENALTIES—Penalties are:
73A801 and Schedules A, A-1, A-2, A-3, A-4 and Schedule B. 
A financial institution whose business activity is taxable   Failure to file a bank franchise tax return by the due date 
both within and without Kentucky must complete               or the extended due date—2 percent of the tax due for 
Schedule C to apportion its net capital.                     each 30 days or fraction thereof that the return is late 
                                                             (maximum 20 percent). The minimum penalty is $10. 
If information for previous tax years 2015, 2014, 2013 and   (KRS 131.180(1))
2012 is the same as reported in prior years, then comple-
tion of Schedules A-1 through A-4 is not required.           Failure to pay bank franchise tax by the due date—
                                                             2 percent of the tax due for each 30 days or fraction thereof 
                                                             that the payment is overdue (maximum 20 percent). The 
RTN (BANK FRANCHISE TAX ACCOUNT                              minimum penalty is $10. (KRS 131.180(2))
NUMBER)—The bank franchise tax account num-
ber is the bank routing and transit number (RTN).            Failure or refusal to file a bank franchise tax return or 
Enter this number in the appropriate box at the top          furnish information requested in writing—5 percent of 
of each form and schedule and on checks and cor-             the tax assessed for each 30 days or fraction thereof that 
respondence. Also enter the federal identification           the return is not filed or the information is not submit-
number where requested.
                                                             ted (maximum 50 percent). The minimum penalty is $25. 
                                                             (KRS 131.180(4))
  SIGNATURE—Form 73A801 must be signed by an 
✍ authorized officer of the financial institution.           Fraud—50 percent of the tax assessed. (KRS 131.180(8))

SUBSTITUTE FORMS—Contact the Department of                   Negligence—10 percent of the tax assessed. (KRS 
Revenue by calling (502) 564-2198 for approval of all        131.180(7))
forms used in lieu of the official Kentucky bank franchise 
tax forms.                                                   Cost of Collection Fees—25 percent on all taxes which 
                                                             become final, due and owing. These collection fees are 
TAXABLE YEAR—"Taxable Year" means calendar year              in addition to all other penalties provided by law. (KRS 
1996 and every calendar year thereafter.                     131.440)

RETURN/PAYMENT DUE DATE—On or before March 15                 Failure to complete forms properly may result in 
following each calendar year, a bank franchise tax            denial of deductions and delays in the issuance of 
return for the preceding taxable                              any refunds.
year  must be filed and payment          MARCH 2017
must be made with the Kentucky    S   M  T   W    T   F  S
                                       1   2 3 4 
Department of Revenue. Mail       5   6  7  8    9  10  11   FORM 73A801—BANK FRANCHISE TAX RETURN
the return with payment to       12  13 14 15 16 17 18 
Kentucky Department of Revenue,  19  20 21 22 23 24 25       INSTRUCTIONS
                                 26  27 28 29 30 31
P.O. Box 1303, Frankfort, 
Kentucky 40602-1303. Make                                    DEFINITION OF NET CAPITAL
your check payable to Kentucky State Treasurer.
                                                             The value of net capital for each year is determined by:
EXTENSION OF TIME TO FILE RETURN—The Kentucky                1.  adding together the book value of:
Department of Revenue will, upon receipt of Form 73A802, 
Application for Extension, on or prior to the due date of     a.  capital stock paid in;
the return, grant an automatic extension of up to 90 days. 
An extension of time to file a return does not extend the      b. surplus;
time for payment of the bank franchise tax. In order to 
prevent the assessment of penalty, the payment must be        c.  undivided profits and capital reserves;
postmarked by March 15 following each calendar year.
                                                              d.  other comprehensive income and equity capital 
A federal extension will not be accepted in lieu of               components; and,
Kentucky Form 73A802.
                                                              e.  noncontrolling (minority) interests in consolidated 
INTEREST—Interest at the "tax interest rate" is applied to        subsidiaries.
all bank franchise tax liabilities not paid by the original 
due date of the return. The computation period is from the    (NOTE:    Equity related to investment in subsidiaries 
original due date of the return to the date of payment.       must be included in the above values.)
                                                            3

2.  deducting from this total an amount equal to the same                 Issuing U.S.
 percentage of the total as the book value of United            Authority                                       Obligation
 States obligations and Kentucky obligations bears 
 to the book value of the total assets of the financial        12.  Federal Home Loan Mortgage Corporation          No
 institution.                                                   (Freddie Mac)
DEFINITION OF UNITED STATES AND KENTUCKY                       13.  Federal Housing Administration                  Yes
OBLIGATIONS                                                    14.  Federal Intermediate Credit Banks               Yes
"United States obligations" means all obligations of the       15.  Federal Land Banks
United States exempt from taxation under 31 U.S.C. sec. 
3124(a) or exempt under the United States Constitution          a. Interest                                         Yes 
or any federal statute, including the obligations of any        b. Dividends from stock issued before 3-28-1942     Yes
instrumentality or agency of the United States that are 
                                                                c. Dividends from stock issued on or after 3-28-1942 No
exempt from state or local taxation under the United States 
Constitution or any statute of the United States.              16.  Federal Land Bank Association                   Yes
"Kentucky obligations" means all obligations of the            17.  Federal Maritime Board and Maritime
Commonwealth of Kentucky, its counties, municipalities,         Administration                                      Yes 
taxing districts and school districts, exempt from taxation    18.  Federal National Mortgage Association           No
under the Kentucky Revised Statutes and the Constitution        (Fannie Mae) 
of Kentucky.
                                                               19.  Federal Reserve Banks
The foregoing book values and deductions for United 
States obligations and Kentucky obligations shall be            a. Interest                                         Yes
determined by the reports of condition for each quarter         b. Dividends from stock issued before 3-28-1942     Yes
filed in accordance with the requirements of the Board 
                                                                c. Dividends from stock issued on or after 3-28-1942 No
of Governors of the Federal Reserve System, the 
Comptroller of the Currency, the Federal Deposit Insurance      d. Stock                                            Yes
Corporation, or other applicable regulatory authority.         20.  Federal Savings and Loan Association
Please note: United States obligations and Kentucky 
obligations classified as Held-to-maturity shall be valued      a. Dividends from stock issued before 3-28-1942     Yes
at Amortized Cost and obligations classified as Available-      b. Dividends from stock issued on or after 3-28-1942 No
for-sale shall be valued at Fair Value.
                                                               21.  Federal Savings and Loan Insurance Corporation  Yes
Securities which are merely "guaranteed" by the United         22.  General Insurance Fund                          Yes
States government are not United States obligations. 
The following list is provided to assist the bank in           23.  Government National Mortgage Association        No
classifying United States obligations. This list is not an      (Ginnie Mae)
all-inclusive list. Obligations not listed may be referred to 
the Department of Revenue for a determination.                 24.  Guam Bonds                                      Yes
                                                               25.  Joint Stock Land Banks                          No
            Issuing U.S.
                                                               26.  National Farm Loan Association                  Yes
 Authority                                        Obligation
                                                               27.  Panama Canal Bond                               Yes
 1.  Commodity Credit Corporation                 Yes
                                                               28.  Production Credit Association or Corporation
 2.  Farm Credit Financial Assistance Corporation Yes 
                                                                a. Interest                                         Yes
 3.  Farmers Home Administration                  No            b. Dividends                                        No
 4.  Farmers Home Corporation                     No           29.  Puerto Rican Bonds                              Yes 
 5.  Federal Credit Union                         Yes          30.  Small Business Administration (SBA)             No
 6.  Federal Deposit Insurance Company            Yes          31.  Student Loan Marketing Association              Yes
 7.  Federal Farm Credit Banks                    Yes          32.  Tennessee Valley Authority                      No
 8.  Federal Farm Loan Corporation                Yes          33.  U.S. Housing Authority                          Yes 
 9.  Federal Financing Corporation                Yes          34.  U.S. Postal Service Bonds                       Yes
10.  Federal Home Loan Banks                      Yes          35.  U.S. Treasury Bonds                             Yes
11.  Federal Home Loan Bank Stock                 Yes          36.  Virgin Island Bonds                             Yes
                                                              4

SCHEDULES A THROUGH A–4 AND SCHEDULE B—                        Line 12—Receipts from the lease or rental or sublease 
COMPUTATION OF NET CAPITAL                                     of real property owned by the financial institution are 
                                                               included in the numerator if the property is located within 
INSTRUCTIONS                                                   Kentucky.

To arrive at the total net capital for the taxable year, net   Line 13—Receipts from the lease or rental of tangible per-
capital is determined by adding the value determined for       sonal property other than transportation property owned 
the current taxable year and the preceding four taxable        by the financial institution are included in the numerator 
years and dividing the resulting sum by five. Schedule         if the property is located within Kentucky when it is first 
A is used to compute net capital for the current year.         placed in service by the lessee. Receipts from the lease or 
Schedules A-1, A-2, A-3 and A-4 are used to compute net        rental of transportation property owned by the financial 
capital for the four preceding years. Schedule B is used       institution are included in the numerator to the extent 
to compute the total net capital for the taxable year.         that the property is used in Kentucky.

If information for previous tax years 2015, 2014, 2013         Line 14—Interest and fees or penalties in the nature of 
and  2012  is  the  same  as  reported  in  prior  years,      interest from loans secured by real property are included 
then  completion  of  Schedules  A-1  through  A-4  is         in the numerator if the secured property is located within 
not required.                                                  Kentucky.

If a financial institution has not been in existence for a     Line 15—Interest and fees or penalties in the nature of 
period of five calendar years, net capital is determined       interest from loans not secured by real property are 
by adding together the values determined for the               included in the numerator if the borrower is located in 
number of calendar years the financial institution has         Kentucky.
been in existence and dividing the resulting sum by
the number of years the financial institution has been in      Line 16—Net gains from the sale of loans secured by real 
existence. A partial year is treated as a full year.           property included in the numerator are determined by 
                                                               multiplying the net gains by a fraction, the numerator 
SCHEDULE C—                                                    of which is the amount of interest and fees or penalties 
APPORTIONMENT OF NET CAPITAL                                   from loans secured by real property located in Kentucky 
                                                               and the denominator of which is the total amount of 
INSTRUCTIONS                                                   interest and fees or penalties from loans secured by 
                                                               real property.
General Instructions—A financial institution whose 
business activity is taxable both within and without           Net gains from the sale of loans not secured by real 
Kentucky must apportion its net capital in accordance          property  included in the numerator are determined by 
with KRS 136.525. The three-factor apportionment               multiplying the net gains by a fraction, the numerator 
formula of receipts, property and payroll is substantially     of which is the amount of interest and fees or penalties 
the same as the Multistate Tax Commission uniformity           from loans not secured by real property from borrowers 
recommendation for financial institution apportionment.        located in Kentucky and the denominator of which is the 
Each factor must be calculated by the method of accounting     total amount of interest and fees or penalties from loans 
used by the financial institution for the taxable year.        not secured by real property.

A financial institution must use the above statutory           Line 17—Interest and fees or penalties in the nature of 
apportionment formula unless the financial institution         interest from credit card receivables and receipts from fees 
has been required or granted approval in writing by the        charged to card holders are included in the numerator if 
Department of Revenue to use a method other than the           the billing address of the card holder is in Kentucky.
statutory formula provided in KRS 136.525. In this event, 
a copy of the letter from the department requiring or          Line 18—Net gains from the sale of credit card receivables 
granting approval to use a method other than the statutory     included in the numerator are determined by multiplying 
formula must be attached to the return when filed.             the net gains by a fraction, the numerator of which is the 
                                                               amount of interest and fees or penalties in the nature of 
Computation of Apportionment Percentage                        interest from credit card receivables and receipts from 
                                                               fees charged to card holders located in Kentucky and the 
Part II—Receipts—The receipts factor is a fraction, the nu-    denominator of which is the financial institution’s total 
merator of which is the receipts of the financial institution  amount of interest and fees or penalties in the nature of 
in Kentucky during the taxable year and the denominator        interest from credit card receivables and fees charged 
of which is the receipts of the financial institution within   to card holders.
and without Kentucky during the taxable year. Receipts 
included in the factor computation and included in the         Line 19—Credit card issuer’s reimbursement fees to be 
numerator are outlined as follows:                             included in the numerator are determined by multiplying 
                                                              5

the amount of fees by a fraction, the numerator of which is        Line 25—Receipts from services not otherwise 
the amount of interest and fees or penalties in the nature         apportioned under this section are included in the 
of interest from credit card receivables and receipts from         numerator if the service is performed in Kentucky. If the 
fees charged to card holders located in Kentucky and the           service is performed both within and without Kentucky, 
denominator of which is the financial institution’s total          the numerator of the receipts factor includes receipts from 
amount of interest and fees or penalties in the nature of          services not otherwise apportioned under this section if 
interest from credit card receivables and fees charged             a greater proportion of the income-producing activity is 
to card holders.                                                   performed in Kentucky based on cost of performance.

Line 20—Receipts from merchant discounts are included in           Throwback Rule—All receipts that would be assigned 
the numerator if the commercial domicile of the merchant           to a state in which the financial institution is not taxable 
is in Kentucky.                                                    are included in the numerator of the receipts factor, 
                                                                   if the financial institution’s commercial domicile is in 
Line 21—Loan servicing fees derived from loans secured             Kentucky.
by real property included in the numerator are determined 
by multiplying the amount of fees by a fraction, the               Parts III and IV—Property—The property factor is a 
numerator of which is the interest and fees or penalties in        fraction, the numerator of which is the average value 
the nature of interest from loans secured by real property         of real property and tangible personal property rented 
located in Kentucky and the denominator of which is the            to the financial institution that is located or used within 
total amount of interest and fees or penalties in the nature       Kentucky during the taxable year, the average value of  the 
of interest from loans secured by real property.                   financial institution’s real and tangible personal property 
                                                                   owned that is located or used within Kentucky during 
Line 22—Loan servicing fees derived from loans not                 the taxable year, and the average value of the financial 
secured by real property included in the numerator                 institution’s loans and credit card receivables that are 
are determined by multiplying the amount of fees by a              located within Kentucky during the taxable year, and the 
fraction, the numerator of which is the amount of interest         denominator of which is the average value of all such 
and fees or penalties in the nature of interest from loans         property located or used within and without Kentucky 
not secured by real property where the borrower is located         during the taxable year. 
in Kentucky and the denominator of which is the total 
amount of interest and fees or penalties in the nature of          The value of real property and tangible personal property 
interest from loans not secured by real property.                  owned by the financial institution is the original cost or 
                                                                   other basis of property for federal income tax purposes 
Line 23—Interest, dividends, net gains, and other income           without regard to depletion, depreciation or amortization. 
from investment assets and activities and from trading             Loans and credit card receivables are valued at their out-
assets and activities included in the numerator are                standing principal balance, without regard to any reserve 
determined by multiplying the income by a fraction, the            for bad debts. 
numerator of which is the average value of the assets 
assigned to a regular place of business of the financial           The average value of property owned by the financial 
institution within Kentucky and the denominator of which           institution is computed on an annual basis by adding 
is the average value of all the assets. In lieu of this fraction,  the value of the property on the first day of the taxable 
the financial institution may elect or the Department of           year and the value on the last day of the taxable year 
Revenue may require in order to fairly represent the               and dividing the sum by two. The average value of real 
business activity of the financial institution, the use of         property and tangible personal property that the financial 
an alternative fraction, the numerator of which is gross           institution has rented from another and which is not 
income from assets and activities which are properly               treated as property owned by the financial institution for 
assigned to a regular place of business of the financial           federal income tax purposes is determined annually by 
institution within Kentucky and the denominator of which           multiplying the gross rents payable during the taxable 
is gross income from all assets and activities.                    year by eight.

Line 24—Sales of tangible personal property are in                 Real property and tangible personal property other than 
Kentucky if:                                                       transportation property owned by or rented to the financial 
                                                                   institution is considered to be located within Kentucky if 
1.  the property is delivered or shipped to a purchaser,           it is physically located, situated or used within Kentucky. 
other than the United States government, or to the                 Transportation property is included in the numerator of 
designee of the purchaser within Kentucky regardless               the property factor to the extent that the property is used 
of the f.o.b. point or other conditions of the sale; or            in Kentucky. If the extent of the use of any transportation 
                                                                   property within Kentucky cannot be determined, then 
2. the property is shipped from an office, store,                  the property is deemed to be used wholly in the state in 
warehouse, factory, or other place of storage in                   which the property has its principal base of operations.  
Kentucky and the purchaser is the United States                    A motor vehicle is deemed to be used wholly in the state 
government.                                                        in which it is registered. The extent to which an aircraft 
                                                                  6

shall be deemed to be used in Kentucky and the amount of      TAX RATE
value that is to be included in the numerator of Kentucky’s 
property factor is determined by multiplying the average      The bank franchise tax rate is 1.1 percent of net capital 
value of the aircraft by a fraction, the numerator of which   after apportionment, if applicable. Each financial 
is the number of landings of the aircraft in Kentucky and     institution regularly engaged in business in Kentucky 
the denominator of which is the total number of landings      shall pay a minimum tax of $300 per year.
of the aircraft everywhere.
                                                              ACCOUNTING PROCEDURES—The book values of net 
A loan is considered to be located within Kentucky if it is   capital and the deductions for United States obligations  
properly assigned to a regular place of business of the       and Kentucky obligations for each year are determined 
financial institution within Kentucky. A loan is properly     by the reports of condition for each quarter filed in 
assigned to the regular place of business with which it                accordance with the requirement of the 
has a preponderance of substantive contacts. Credit card               Board of Governors of the Federal Reserve 
receivables will be treated as loans and be subject to the             System, the Comptroller of the Currency, the 
same provisions. A loan that has been properly assigned                Federal Deposit Insurance Corporation, or 
to a state will remain assigned to that state for the length  other applicable regulatory authority. Book values must 
of the original term of the loan.                             be calculated by averaging the quarterly book values 
                                                              as determined by the reports of condition. In the case 
Part I, Lines 7, 8 and 9—Payroll—The payroll factor is a      of a financial institution which does not file reports of 
fraction, the numerator of which is the total amount paid     condition, book values must be determined in accordance 
in Kentucky during the taxable year by the financial insti-   with generally accepted accounting principles.
tution for compensation and the denominator of which 
is the total compensation paid both within and without        CHANGES IN IDENTITY OR FORM
Kentucky during the taxable year. The com pensation of 
any employee for services or activities which are not         A change in identity, form or place of organization of 
connected with business activities and payments made          one financial institution will be treated as if a single 
to any independent contractor or any other person not         financial institution had been in existence prior to as 
properly classified as an employee will be excluded from      well as after the change. The combination of two or 
both the numerator and denominator of the factor.             more financial institutions into one will be treated as if 
                                                              the constituent financial institutions had been a single 
Compensation is paid in Kentucky if any of the following      financial institution in existence prior to as well as after 
tests is met:                                                 the combination and the book values and 
                                                              deductions for United States obligations 
a.  The employee’s services are performed entirely within     and Kentucky obligations from the reports of 
 Kentucky.                                                    condition of the constituent institutions will 
                                                              be combined. A combination includes any 
b.  The employee’s services are performed both within         acquisition required to be counted for by the 
 and without Kentucky, but the service performed              surviving financial institution under the pooling of interest 
 without Kentucky is incidental to the employee’s             method in accordance with generally accepted accounting 
 service within Kentucky.                                     principles or a statutory merger or consolidation.

c.  If the employee’s services are performed both within      The combination of one or more financial institutions 
 and without Kentucky, the employee’s compensation            and one or more savings and loan associations taxable 
 will be attributed to Kentucky if:                           under KRS 136.300 into a single financial institution shall 
                                                              be treated for the taxable year in which the combination 
 1.  the employee’s principal base of operation is            occurs as if the single financial institution had been in 
 within  Kentucky;                                            existence prior to as well as after the combination. To 
                                                              determine the book values and deductions for United 
 2.  there is no principal base of operation in any state     States and Kentucky obligations for the year of the 
 in which some part of the services are performed,            combination as well as the four preceding taxable years 
 but the place from which the services are directed           the reports of condition of the financial institution and 
 or controlled is in Kentucky; or                             the reports to the federal regulatory agency for a savings 
                                                              and loan association which are the equivalent of the 
 3.  the principal base of operation and the place from 
                                                              reports of condition of a financial institution must be 
 which the services are directed or controlled are 
                                                              combined.
 not in any state in which some part of the service 
 is performed but the employee’s residence is in 
                                                              The conversion of a savings and loan association taxable 
 Kentucky.
                                                              under KRS 136.300 into a financial institution shall be 
                                                              treated for the taxable year in which the conversion 
 Complete Line 8 of Schedule C even if Line 7 is zero.        occurs as if the savings and loan association had 
                                                              been a financial institution prior to as well as after the 

                                                             7

conversion. To determine the book values and deductions      Corbin, 15100 North US25E, Suite 2, 40701-6188
for United States and Kentucky obligations for the year        (606) 528-3322
of the conversion as well as the four preceding taxable 
years, the reports to the federal regulatory agency for a    Frankfort, 501 High Street, 40601-2103
savings and loan association which are the equivalent          (502) 564-4581 (Taxpayer Assistance)
of the reports of condition of a financial institution must 
be used.                                                     Hopkinsville, 181 Hammond Drive, 42240-7926
                                                               (270) 889-6521
The savings and loan association shall not be relieved 
of the responsibilities of filing and paying tax under       Louisville, 600 W. Cedar Street, 2nd Floor W., 40202-2310  
KRS 136.300 for taxable years prior to the year of any        (502) 595-4512
combination or conversion.
                                                             Northern Kentucky, Turfway Ridge Office Park 
A financial institution resulting from a combination with      7310 Turfway Road, Suite 190
or conversion of a savings and loan association shall          Florence, 41042-4871
receive a credit on the bank franchise tax return filed for    (859) 371-9049
the year of the combination or conversion equal to the 
amount of tax paid under KRS 136.300 for the assessment      Owensboro, 401 Frederica Street,
date occurring within the taxable year during which the        Building C, Suite 201, 42301-6295
combination or conversion takes place.                         (270) 687-7301

TAXPAYER ASSISTANCE                                          Paducah, Clark Business Complex, Suite G
                                                               2928 Park Avenue, 42001-4024
Information and Forms:                                         (270) 575-7148

Miscellaneous Tax Branch                                     Pikeville, Uniplex Center
Department of Revenue                                         126 Trivette Drive, Suite 203, 41501-1275
P.O. Box 1303                                                  (606) 433-7675
Frankfort, KY  40602-1303

(502) 564-2198
(502) 564-3058 (Telecommunication Device for the Deaf)
www.revenue.ky.gov (Internet)

KENTUCKY TAXPAYER SERVICE CENTERS

Information and forms are available from Kentucky Tax-
payer Service Centers in the following cities.
                                                              The Kentucky Department of Revenue does not 
Ashland, 1539 Greenup Avenue, 41101-7695                      discriminate on the basis of race, color, national origin, 
  (606) 920-2037                                              sex, age, religion, disability, sexual orientation, gender 
                                                              identity, veteran status, genetic information or ancestry 
                                                              in employment or the provision of services.
Bowling Green, 201 West Professional Park Court
 42104-3278
  (270) 746-7470                                                                      Printing costs paid from state funds.

                                                            8

73A801 (1-17)
                                                                                                         FOR OFFICIAL USE ONLY
Commonwealth of Kentucky
DEPARTMENT OF REVENUE
                                                                                    __ __ / __ __ __ __ __ __ __    __ __ / __ __ / __ __ __ __         8 8   0 1   2 0 1 6
                                                                                                    RTN                                                 Type  Type     Period
                                                                                                                                                        Tax    Return

                                                             BANK FRANCHISE TAX RETURN
                                                                    FINANCIAL INSTITUTIONS
                               For calendar year January 1, 2016, through December 31, 2016                                                               
Name                                                                                                     RTN (Routing and Transit Number)
                                                                                                         _ _ /_ _ _ _ _ _ _
Mailing Address                                                                                          Federal Identification Number
                                                                                                         _ _  —                                         _ _ _ _ _ _ _
City                           County                                        State          ZIP Code
                                                                                                         Check applicable box.

                                                                                                          Original Return
Telephone Number        E-mail                                                                            
(   )                                                                                                     Amended Return
                                                                                                          
COMPUTATION OF BANK FRANCHISE TAX

 1.  Total net capital (from Schedule B, line 7) .......................................................................................
 2.  Apportionment percentage (from Schedule C, line 11) (see instructions) ....................................
 3.  Taxable net capital (line 1 x line 2) ...................................................................................................
 4.  Tax liability (line 3 x .011 or $300, whichever is larger) ..................................................................
 5.   Kentucky Investment Fund Act Credit                           Kentucky Historic Preservation Credit ............
 6.  Tax liability after credit (subtract line 5 from line 4) .......................................................................
 7.  Adjustments .......................................................................................................................................
 8.  Interest and penalty (see instructions) ............................................................................................
 9.  Total liability (add lines 6, 7 and 8) ...................................................................................................
10.  Amount paid with extension/original ..............................................................................................
11.  Amount overpaid (If line 10 exceeds line 9, enter the difference here and complete line 13
     or 14. If neither line 13 nor 14 is completed, amount will be credited to 2017.) ...........................
12.  Credit from previous years ...............................................................................................................
13.  Credit amount to 2017 bank franchise tax .......................................................................................
14.  Refund amount (If payment was originally made by electronic funds transfer (EFT),
     and you elect to receive a refund by EFT, check here                    and complete the EFT
     information on page 9.) ....................................................................................................................
15.  Amount due (If line 9 exceeds line 10 + line 12, enter difference here.) .......................................
 
Signature of principal officer or chief accounting officer          Date     Name and Social Security or federal identification number of person or firm preparing return
                                                                         ➤  Make check payable to Kentucky State Treasurer and mail return with payment to:
Print or type name of principal officer or chief accounting officer                                      Kentucky Department of Revenue
                                                                            Mailing Address:             P.O. Box 1303, Frankfort, KY 40602-1303
                                                                            Overnight Address:           501 High Street, Frankfort, KY 40601-2103

                        Do you want to allow another person to discuss this return with the DOR (see instructions)?
THIRD PARTY
                        Designee's Phone
DESIGNEE
                        Name                                                                        No.  ä

73A801 (2016)                                                                                                                                   Page 2
Name RTN                                                                    (Routing and Transit Number)

                                                       SCHEDULE A

PART I—Computation of Calendar Year 2016 Net Capital
Date of
Incorporation  ➤                           First Quarter Second Quarter     Third Quarter                                                Fourth Quarter

 1.  Capital stock paid in

 2. Surplus

 3.  Undivided profits and capital reserves
 4.  Other comprehensive income
     and equity capital components
 5.  Noncontrolling (minority) interests 
     in consolidated subsidaries

 6.  Totals of net capital

PART II— Computation of Calendar Year 2016 Average Values of Net Capital,
           United States Obligations, Kentucky Obligations and Total Assets 
                                           A B C  D
           Period                 Totals of Net Capital U.S. Obligations    Kentucky                                                     Total Assets
                                         (from line 6)                      Obligations

 7.  First quarter

 8.  Second quarter

 9.  Third quarter

10.  Fourth quarter

11.  Totals

12.  Average values
     (divide line 11 by 4)

PART III—Computation of Deduction for United States Obligations and Kentucky Obligations
13.  Average value of net capital (from line 12, Column A) ...................................................................
14.  Average value of United States obligations (from line 12, Column B) .........................................
15.  Average value of Kentucky obligations (from line 12, Column C) .................................................
16.  Total United States and Kentucky obligations (add lines 14 and 15) ............................................
17.  Average value of total assets (from line 12, Column D) .................................................................
18.  Divide line 16 by line 17 (carry to six places) ..................................................................................
19.  Deduction for United States and Kentucky obligations (multiply line 13 by line 18)...................
PART IV—Computation of Calendar Year 2016 Value

20.  Value of calendar year 2016 net capital (subtract line 19 from line 13)
     (enter here and on Schedule B, line 1) .............................................................................................

73A801 (2016)                                                                                                                                   Page 3
Name RTN                                                                    (Routing and Transit Number)

                                                       SCHEDULE A-1

PART I—Computation of Calendar Year 2015 Net Capital
Date of
Incorporation  ➤                           First Quarter Second Quarter     Third Quarter                                                Fourth Quarter

 1.  Capital stock paid in

 2. Surplus

 3.  Undivided profits and capital reserves
 4.  Other comprehensive income
     and equity capital components
 5.  Noncontrolling (minority) interests 
     in consolidated subsidaries

 6.  Totals of net capital

PART II— Computation of Calendar Year 2015 Average Values of Net Capital,
           United States Obligations, Kentucky Obligations and Total Assets
                                           A B C  D
           Period                 Totals of Net Capital U.S. Obligations    Kentucky                                                     Total Assets
                                         (from line 6)                      Obligations

 7.  First quarter

 8.  Second quarter

 9.  Third quarter

10.  Fourth quarter

11.  Totals

12.  Average values
     (divide line 11 by 4)

PART III—Computation of Deduction for United States Obligations and Kentucky Obligations
13.  Average value of net capital (from line 12, Column A) ...................................................................
14.  Average value of United States obligations (from line 12, Column B) .........................................
15.  Average value of Kentucky obligations (from line 12, Column C) .................................................
16.  Total United States and Kentucky obligations (add lines 14 and 15) ............................................
17.  Average value of total assets (from line 12, Column D) .................................................................
18.  Divide line 16 by line 17 (carry to six places) ..................................................................................
19.  Deduction for United States and Kentucky obligations (multiply line 13 by line 18)...................
PART IV—Computation of Calendar Year 2015 Value

20.  Value of calendar year 2015 net capital (subtract line 19 from line 13)
     (enter here and on Schedule B, line 2) .............................................................................................

73A801 (2016)                                                                                                                                   Page 4
Name RTN                                                                    (Routing and Transit Number)

                                                       SCHEDULE A-2

PART I—Computation of Calendar Year 2014 Net Capital
Date of
Incorporation  ➤                           First Quarter Second Quarter     Third Quarter                                                Fourth Quarter

 1.  Capital stock paid in

 2. Surplus

 3.  Undivided profits and capital reserves
 4.  Other comprehensive income
     and equity capital components
 5.  Noncontrolling (minority) interests 
     in consolidated subsidaries

 6.  Totals of net capital

PART II— Computation of Calendar Year 2014 Average Values of Net Capital,
           United States Obligations, Kentucky Obligations and Total Assets
                                           A B C  D
           Period                 Totals of Net Capital U.S. Obligations    Kentucky                                                     Total Assets
                                         (from line 6)                      Obligations

 7.  First quarter

 8.  Second quarter

 9.  Third quarter

10.  Fourth quarter

11.  Totals

12.  Average values
     (divide line 11 by 4)

PART III—Computation of Deduction for United States Obligations and Kentucky Obligations
13.  Average value of net capital (from line 12, Column A) ...................................................................
14.  Average value of United States obligations (from line 12, Column B) .........................................
15.  Average value of Kentucky obligations (from line 12, Column C) .................................................
16.  Total United States and Kentucky obligations (add lines 14 and 15) ............................................
17.  Average value of total assets (from line 12, Column D) .................................................................
18.  Divide line 16 by line 17 (carry to six places) ..................................................................................
19.  Deduction for United States and Kentucky obligations (multiply line 13 by line 18)...................
PART IV—Computation of Calendar Year 2014 Value

20.  Value of calendar year 2014 net capital (subtract line 19 from line 13)
     (enter here and on Schedule B, line 3) .............................................................................................

73A801 (2016)                                                                                                                                   Page 5
Name RTN                                                                    (Routing and Transit Number)

                                                       SCHEDULE A-3

PART I—Computation of Calendar Year 2013 Net Capital
Date of
Incorporation  ➤                           First Quarter Second Quarter     Third Quarter                                                Fourth Quarter

 1.  Capital stock paid in

 2. Surplus

 3.  Undivided profits and capital reserves
 4.  Other comprehensive income
     and equity capital components
 5.  Noncontrolling (minority) interests 
     in consolidated subsidaries

 6.  Totals of net capital

PART II— Computation of Calendar Year 2013 Average Values of Net Capital,
           United States Obligations, Kentucky Obligations and Total Assets
                                           A B C  D
           Period                 Totals of Net Capital U.S. Obligations    Kentucky                                                     Total Assets
                                         (from line 6)                      Obligations

 7.  First quarter

 8.  Second quarter

 9.  Third quarter

10.  Fourth quarter

11.  Totals

12.  Average values
     (divide line 11 by 4)

PART III—Computation of Deduction for United States Obligations and Kentucky Obligations
13.  Average value of net capital (from line 12, Column A) ...................................................................
14.  Average value of United States obligations (from line 12, Column B) .........................................
15.  Average value of Kentucky obligations (from line 12, Column C) .................................................
16.  Total United States and Kentucky obligations (add lines 14 and 15) ............................................
17.  Average value of total assets (from line 12, Column D) .................................................................
18.  Divide line 16 by line 17 (carry to six places) ..................................................................................
19.  Deduction for United States and Kentucky obligations (multiply line 13 by line 18)...................
PART IV—Computation of Calendar Year 2013 Value

20.  Value of calendar year 2013 net capital (subtract line 19 from line 13)
     (enter here and on Schedule B, line 4) .............................................................................................

73A801 (2016)                                                                                                                                   Page 6
Name RTN                                                                    (Routing and Transit Number)

                                                       SCHEDULE A-4

PART I—Computation of Calendar Year 2012 Net Capital
Date of
Incorporation  ➤                           First Quarter Second Quarter     Third Quarter                                                Fourth Quarter

 1.  Capital stock paid in

 2. Surplus

 3.  Undivided profits and capital reserves
 4.  Other comprehensive income
     and equity capital components
 5.  Noncontrolling (minority) interests 
     in consolidated subsidaries

 6.  Totals of net capital

PART II— Computation of Calendar Year 2012 Average Values of Net Capital,
           United States Obligations, Kentucky Obligations and Total Assets
                                           A B C  D
           Period                 Totals of Net Capital U.S. Obligations    Kentucky                                                     Total Assets
                                         (from line 6)                      Obligations

 7.  First quarter

 8.  Second quarter

 9.  Third quarter

10.  Fourth quarter

11.  Totals

12.  Average values
     (divide line 11 by 4)

PART III—Computation of Deduction for United States Obligations and Kentucky Obligations
13.  Average value of net capital (from line 12, Column A) ...................................................................
14.  Average value of United States obligations (from line 12, Column B) .........................................
15.  Average value of Kentucky obligations (from line 12, Column C) .................................................
16.  Total United States and Kentucky obligations (add lines 14 and 15) ............................................
17.  Average value of total assets (from line 12, Column D) .................................................................
18.  Divide line 16 by line 17 (carry to six places) ..................................................................................
19.  Deduction for United States and Kentucky obligations (multiply line 13 by line 18)...................
PART IV—Computation of Calendar Year 2012 Value

20.  Value of calendar year 2012 net capital (subtract line 19 from line 13)
     (enter here and on Schedule B, line 5) .............................................................................................

73A801 (2016)                                                                                                                                      Page 7
Name RTN                                                                                                               (Routing and Transit Number)

                                SCHEDULE B

COMPUTATION OF TOTAL NET CAPITAL

Values of net capital:
 1.  Calendar year 2016 (Schedule A, line 20) ........................................................................................

 2.  Calendar year 2015 (Schedule A-1, line 20) ..................................................................................... 

 3.  Calendar year 2014 (Schedule A-2, line 20) .....................................................................................

 4.  Calendar year 2013 (Schedule A-3, line 20) .....................................................................................

 5.  Calendar year 2012 (Schedule A-4, line 20) .....................................................................................

 6.  Add lines 1 through 5 ........................................................................................................................

 7.  Taxable amount of total net capital (line 6 divided by 5 or the number of years
 in existence if less than 5) (enter here and on page 1, line 1) .......................................................

                                SCHEDULE C
                      (For financial institutions taxable both within and without Kentucky.)

Part I—Computation of Apportionment Percentage

 1.  Kentucky receipts (from Schedule C, line 26, Column A) ................................

 2.  Total receipts (from Schedule C, line 26, Column B) .......................................

 3.  Receipts factor (line 1 divided by 2) (carry to four decimal places) ............................................................... %

 4.  Average value of Kentucky property (from Schedule C, line 34) ....................

 5.  Average value of total property (from Schedule C, line 42) ............................
 
 6.  Property factor (line 4 divided by line 5) (carry to four decimal places) ........................................................ %

 7.  Kentucky payroll .................................................................................................

 8.  Total payroll (complete this line even if line 7 is zero)  ...................................

 9.  Payroll factor (line 7 divided by line 8) (carry to four decimal places) ........................................................... %

10.  Total (lines 3, 6 and 9) ........................................................................................................................................ %
11.  Apportionment percentage—line 10 divided by 3 or number of factors present
 (enter here and on page 1, line 2) (carry to four decimal places) ................................................................... %

See Instructions

 73A801 (2016)                                                                                                                                               Page 8
Name RTN                                                                                                                         (Routing and Transit Number)

PART II—Receipts
                                                                                                                                 A                     B
                                                                                                                                 Kentucky              Total

12.  Receipts from lease or rental of real property .........................................................

13.  Receipts from lease or rental of tangible personal property ..................................

14.  Interest from loans secured by real property ...........................................................

15.  Interest from loans not secured by real property ....................................................

16.  Net gains from the sale of loans ...............................................................................

17.  Interest from credit card receivables and fees charged to card holders ...............

18.  Net gains from sale of credit card receivables .........................................................

19.  Credit card issuer’s reimbursement fees ..................................................................

20.  Receipts from merchant discount .............................................................................

21.  Loan servicing fees from loans secured by real property .......................................

22.  Loan servicing fees from loans not secured by real property ................................
23.  Interest, dividends, net gains, and other income from investment
    and trading assets and activities ...............................................................................

24.  Receipts of sales of tangible personal property ......................................................

25.  Other receipts .............................................................................................................
26.  Totals (add lines 12 through 25)
    (enter here and on Schedule C, lines 1 and 2) .........................................................
                  PART III—Kentucky Property                                                                                     PART IV—Total Property
                                               A. Beginning B. End                                                               A. Beginning          B. End
     PROPERTY                                  of Year      of Year          PROPERTY                                              of Year             of Year

27. Loans and credit                                                35. Loans and credit
    card receivables .................                               card receivables ................
 
28.  Premises and                                                   36. Premises and
    fixed assets ........................                            fixed assets ....................... 
29.  Other real                                                     37. Other real
    estate owned......................                               estate owned .....................
30.  Other real and tangible                                        38. Other real and tangible
    personal property ..............                                 personal property ............. 
31.  Total                                                          39. Total
    (lines 27 through 30) .........                                  (lines 35 through 38) ........
32.  Average value (total of                                        40. Average value (total of 
    line 31, columns A                                               line 39, columns A
    and B, divided by 2) ..........                                  and B, divided by 2) ..........
33.  Rented property                                                41. Rented property
    (eight times the gross                                           (eight times the gross
    rents payable) ....................                              rents payable) ...................
34.  Total (lines 32 and 33)                                        42. Total (lines 40 and 41)
    (enter on Schedule C,                                            (enter on Schedule C,
    line 4) ..................................                       line 5) ................................. 

See Property Factor Instructions                                    See Property Factor Instructions

 73A801 (2016)                                                                                                    Page 9
 Name RTN                                                                             (Routing and Transit Number)

 COMBINED FINANCIAL INSTITUTIONS
 If the financial institution filed a 2015 Kentucky bank franchise tax return, identify financial institutions combined with the 
 taxpayer during 2016, complete Schedules A through A-4, and submit a schedule disclosing amounts of net capital of the 
 combined entities. If this return is the first Kentucky bank franchise tax return filed, identify financial institutions combined 
 with the taxpayer during the last five tax years and the date combined. Submit a schedule disclosing amounts of net capital 
 of combined entities included in Schedules A through A-4 attached (see instructions).

                                                                                                   RTN
                                 Name                                 Date Combined                (Routing and
                                                                                                   Transit Number)

 OFFICER INFORMATION
                                                                                               Social Security Number
 Last Name        First Name          M.I.                     Address
                                                                                                   Telephone Number
   President or CEO                                                                                - -

                                                                                               (   )
  
                  Vice President                                                                 - -

                                                                                               (   )
                  Secretary                                                                      - -

                                                                                               (   )
                  Treasurer                                                                      - -

                                                                                               (   )
 •  For additional information or questions concerning the bank franchise tax, contact the Excise Tax Section at 
  (502) 564-2198.
 •  For information or questions concerning electronic funds transfer (EFT), contact the Electronic Commerce Group 
  at 1-800-839-4137, (502) 564-6020 or online at revenue.ky.gov/TPS
  Banking Information (if EFT refund requested): Name of Bank
                                                                                                           Account Type
 Depositor Account Number (DAN) __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __                          Checking
                                                                                                             Savings 
 Routing Transit Number (RTN) __ __ __ __ __ __ __ __ __                                                    Other 
 If different than current address, mail next year's return to:

  Name                                                         Telephone Number (   )

 Address

No text to extract.

73A802 (1-17)
                                                                                              FOR OFFICIAL USE ONLY
Commonwealth of Kentucky
DEPARTMENT OF REVENUE
                                                                             __ __ / __ __ __ __ __ __ __    __ __ / __ __ / __ __ __ __ 8 8   0 4   2 0 1 6
                                                                                           RTN                         Type  Type     Period
                                                                                                                       Tax    Return

                                                                            APPLICATION FOR
                                         90-DAY EXTENSION OF TIME TO FILE
                                 KENTUCKY BANK FRANCHISE TAX RETURN
                Name                                                          RTN (Routing and Transit Number)
                                                                              _ _ /        _ _ _ _ _ _ _
                Mailing Address                                               Federal Identification Number
                                                                              _ _ —_ _ _ _ _ _ _                                     
                                                                              Telephone Number
                                                                              (   )  
  Print or Type City                                                         State           ZIP Code

                Email                                                                         

  1.  Tentative payment of bank franchise tax due (see instructions) ..................................................

  2.  If remitting payment by electronic funds transfer (EFT), check here  and enter amount ........

                                ➤ Make check payable to Kentucky State Treasurer and mail extension request with payment to:
  Kentucky Department of Revenue
                                 Mailing Address:   P. O. Box 1303, Frankfort, KY 40602-1303
                                 Overnight Address: 501 High Street, Frankfort, KY 40601-2103 
                                 Telephone Number:  (502) 564-2198            

Extensions are granted in accordance with the provisions of Kentucky Revised Statute 136.545.

                 Signature of Principal Officer or Chief Accounting Officer                Signature of Preparer Other Than Taxpayer

                                                                             
  Type or Print Name of Principal Officer or Chief Accounting Officer                      Telephone Number           Extension

 Date

  The 2016 Kentucky bank franchise tax return must be postmarked no later than March 15, 2017, 
  unless an extension of time to file the return is submitted by that date. If a 90-day extension of time 
  is requested, the 2016 Kentucky bank franchise tax return must be postmarked no later than June 
  13, 2017. An extension of time to file a return does not extend the time for payment of the tax due.

No text to extract.

73A800 (1-17)
Commonwealth of Kentucky              KENTUCKY REGISTRATION APPLICATION                                FOR  OFFICIAL USE ONLY
DEPARTMENT OF REVENUE                                               FOR
                                                        BANK FRANCHISE TAX

 Is the financial institution subject to the Kentucky bank franchise tax?      Yes   No   (See reverse.)
 Was the financial institution previously subject to the Kentucky bank shares tax?         Yes    No
 Reason for filing this application:  Initial application          Change in ownership    Other                                      
MAILING ADDRESS FOR THE BANK FRANCHISE TAX RETURN

Legal Business Name                                                                        RTN (Routing and Transit Number)
                                                                                           _ _  /  _ _ _ _ _ _ _
Street Address                                                                             Federal Identification Number
                                                                                           _ _ — _ _ _ _ _ _ _
Post Office Box Number                                                                     Telephone Number
                                                                                           (   )
City                                                                                  State            ZIP Code

Email

OFFICER INFORMATION (President or CEO, Vice President, Secretary, Treasurer, Other)

Last Name                First Name                                 M.I.             Title             Social Security Number

     Print or Type Name of Person Preparing Application                  Title                             Telephone Number

Address                                                 City                                 State                         ZIP Code 

        ➤ To register to pay the bank franchise tax by electronic funds transfer (EFT), contact the Electronic 
          Commerce Group at 1-800-839-4137, (502) 564-6020 or online at revenue.ky.gov for an EFT 
          application.
➤ IMPORTANT: APPLICATION MUST BE SIGNED BELOW BY AN OFFICER. The statements contained in this application and any accompanying 
 schedules are hereby certified to be correct to the best knowledge and belief of the undersigned who is duly authorized to sign this 
 application.

 Print or Type Name of Principal Officer or Chief Financial Officer            Signature of Principal Officer or Chief Financial Officer 

 Title                                                                  Mail completed application to Kentucky Department of Revenue,
                                                                         P. O.  Box 1303, Frankfort, Kentucky 40602-1303, or fax to
 Date                                                                    (502) 564-3393.

   WHO MUST FILE THE KENTUCKY BANK FRANCHISE TAX RETURN

Every financial institution regularly engaged in business in Kentucky at any time during the taxable year must 
file a Kentucky Bank Franchise Tax Return, Form 73A801. A financial institution is presumed to be regularly 
engaging in business in Kentucky if during any taxable year it obtains or solicits business with 20 or more 
persons within Kentucky, or if receipts attributable to sources in Kentucky equal or exceed $100,000. 

"Financial institution" means:

a. a national bank organized as a body corporate and existing or in the process of organizing as 
   a national bank association pursuant to the provisions of the National Bank Act, 12 U.S.C. sec. 
   21 et seq., in effect on December 31, 1997, exclusive of any amendments made subsequent to 
   that date;

b. any bank or trust company incorporated or organized under the laws of any state, except a 
   banker’s bank organized under KRS 287.135;

c. any corporation organized under the provisions of 12 U.S.C. secs. 611 to 631, in effect on 
   December 31, 1997, exclusive of any amendments made subsequent to that date, or any 
   corporation organized after December 31, 1997, that meets the requirements of 12 U.S.C. secs. 
   611 to 631, in effect on December 31, 1997; or

d. any agency or branch of a foreign depository as defined in 12 U.S.C. sec. 3101, in effect on 
   December 31, 1997, exclusive of any amendments made subsequent to that date, or any agency or 
   branch of a foreign depository established after December 31, 1997, that meets the requirements 
   of 12 U.S.C. sec. 3101 in effect on December 31, 1997.

The bank franchise tax is in lieu of all city, county and local taxes, except the real estate transfer tax levied 
in KRS Chapter 142, real property and tangible personal property taxes levied in KRS Chapter 132, the local 
franchise tax levied in KRS 136.575, and taxes upon users of utility services. Every financial institution regularly 
engaged in business in Kentucky will be subject to all state taxes except the corporation income tax levied in 
KRS Chapter 141 and the corporation license tax levied in KRS Chapter 136.

Any financial institution subject to the Kentucky bank franchise tax that fails to file a return or that fails to 
pay the tax as listed on the return shall not maintain an action, suit or proceeding in any court or before 
any agency in Kentucky or enforce in any way any obligation of any debts until the return is filed and the 
tax listed on the return is paid.

The president, vice president, secretary, treasurer or any other person holding any equivalent corporate office 
of any financial institution subject to the bank franchise tax will be personally and individually liable, jointly 
and severally, in the event that the financial  institution is unable to make payment. Neither the corporate 
dissolution or withdrawal of the financial institution from Kentucky nor the cessation of holding any corporate 
office will discharge the liability. The personal and individual liability will apply to each and every person 
holding a corporate office at the time the taxes become or became due. No person will be personally and 
individually liable if that person did not have authority in the management of the business or financial affairs 
of the financial institution at the time the taxes become or became due.

RTN (BANK FRANCHISE TAX ACCOUNT NUMBER)

The routing and transit number (RTN) will be the financial institution's bank franchise tax account 
number. This number must be listed in the appropriate space on the reverse.

                    YOUR RIGHTS AS A KENTUCKY TAXPAYER

As a Kentucky taxpayer, you have the right to expect the DOR        Guarantee—You have the right to a guarantee that DOR 
to honor its mission and uphold your rights every time you          employees are not paid, evaluated or promoted based on taxes 
contact or are contacted by the DOR.                                assessed or collected, or a tax assessment or collection quota 
                                                                    or goal imposed or suggested. 
RIGHTS OF TAXPAYER 
                                                                    Damages—You have the right to file a claim for actual and direct 
Privacy—You have the right to privacy of information provided       monetary damages with the Kentucky Board of Claims if a DOR 
to the DOR.                                                         employee willfully, recklessly and intentionally disregards your 
                                                                    rights as a Kentucky taxpayer. 
Assistance—You have the right to advice and assistance from 
the DOR in complying with state tax laws.                           Interest—You may have the right to receive interest on an 
                                                                    overpayment of tax.
Explanation—You have the right to a clear and concise 
explanation of:                                                     DEPARTMENT OF REVENUE RESPONSIBILITIES 
•  basis of assessment of additional taxes, interest and penalties, 
 or the denial or reduction of any refund or credit claim;          The DOR has the responsibility to: 
• procedure for protest and appeal of a determination of the        • perform audits, conduct conferences and hearings with you 
 DOR; and                                                             at reasonable times and places; 
                                                                    •  authorize, require or conduct an investigation or surveillance 
•  tax laws and changes in tax laws so that you can comply with       of you only if it relates to a tax matter; 
 the law. 
                                                                    •  make a written request for payment of delinquent taxes which 
Protest and Appeal—You have the right to protest and appeal a         are due and payable at least 30 days prior to seizure and sale 
determination of the DOR if you disagree with an assessment of        of your assets; 
tax or penalty, reduction or a denial of a refund, a revocation of  •  conduct educational and informational programs to help you 
a license or permit, or other determination made by the DOR.          understand and comply with the laws; 
If you file a timely protest, you have a right to a conference to   •  publish clear and simple statements to explain tax procedures, 
discuss the matter.                                                   remedies, your rights and obligations, and the rights and 
                                                                      obligations of the DOR; 
Representation—You have the right to representation by your 
authorized agent (attorney, accountant or other person) in any      •  notify you in writing when an erroneous lien or levy is released 
hearing or conference with the DOR. You have the right to be          and, if requested, notify major credit reporting companies in 
informed of this right prior to the conference or hearing. If         counties where lien was filed; 
you intend for your representative to attend the conference         • advise you of procedures, remedies and your rights and 
or hearing in your place, you may be required to give your            obligations with an original notice of audit or when an original 
representative a power of attorney before the DOR can discuss         notice of tax due is issued, a refund or credit is denied or 
tax matters with your authorized agent.                               reduced, or whenever a license or permit is denied, revoked 
                                                                      or canceled; 
Recordings—You have the right to make an audio recording of 
                                                                    • notify you in writing prior to termination or modification of 
any meeting, conference, or hearing with the DOR. The DOR 
                                                                      a payment agreement; 
has the right to make an audio recording, if you are notified 
in writing in advance or if you make a recording. You have the      • furnish copies of the agent’s audit workpapers and a written 
right to receive a copy of the recording.                             narrative explaining the reason(s) for the assessment; 
                                                                    • resolve tax controversies on a fair and equitable basis at the 
Consideration—You have the right to consideration of:                 administrative level whenever possible; 
•  waiver of penalties or collection fees if “reasonable cause” for • notify you in writing at  your last known address at least 60 
 reduction or waiver is given (“reasonable cause” is defined          days prior to publishing your name on a list of delinquent 
 in KRS 131.010(9) as: “an event, happening, or circumstance          taxpayers for which a tax or judgment lien has been filed; 
 entirely beyond the knowledge or control of a taxpayer who           and
 has exercised due care and prudence in the filing of a return      • notify you by certified mail 20 days prior to submitting name to 
 or report or the payment of monies due the department                the relevant agency for the revocation or denial of professional 
 pursuant to law or administrative regulation”);                      license, driver’s license or motor vehicle registration.
• installment payments of delinquent taxes, interest and 
 penalties;                                                                  * * * * * * * * * * * * * * 
•  waiver of interest and penalties, but not taxes, resulting from 
 incorrect written advice from the DOR if all facts were given      This information merely summarizes your rights as a Kentucky 
 and the law did not change or the courts did not issue a ruling    taxpayer and the responsibilities of the Department of Revenue. 
 to the contrary;                                                   The Kentucky Taxpayers’ Bill of Rights may be found in the 
                                                                    Kentucky Revised Statutes (KRS) at Chapter 131.041—131.083. 
• extension of time for filing reports or returns; and              Additional rights and responsibilities are provided for in KRS 
• payment of charges incurred resulting from an erroneous           131.020, 131.110, 131.170, 131.1817, 131.183, 131.190, 131.500,  
 filing of a lien or levy by the DOR.                               131.654, 133.120, 133.130, 134.580 and 134.590.

No text to extract.