Louisville Metro Revenue Commission 
           Annual Federal Employee                                                                             2020
                                                                                                                     Form 
           Occupational License Tax Return                                                                                I-2

 CHECK IF CHANGE IN ADDRESS IS BELOW

Last name                            First name                                         MI                     Employer Account ID 
                                                                                                           (only if requesting a refund) 

Address (number and street)                                                    Unit/Apt. no.                   Your Account ID 
                                                                                                               (only if tax is due) 

City, town, or post office                       State                         Zip code                    Social Security Number 

Email                                            Phone no.                     Ext.                            Tax Year Ending 

Income       Applies only if at least 5% of time worked was spent outside Louisville Metro, KY. Please use the formula below to compute 
             any deduction for wages earned outside of Louisville Metro, KY. 
earned 
             A             Number of days worked outside Louisville Metro, KY                                  A 
Outside 
             B             Total number of days worked (excluding holidays, vacation, & sick days)             B 
Louisville 
             C             Percentage of days worked outside Louisville Metro, KY (Divide A by B)              C 
Metro, KY                                                                                                                                % 
             D             Total gross earnings (including deferred compensation and non-cash fringe benefits) D   $                     .00 
             E             Income earned outside Louisville Metro, KY (Multiply D by C)                        E   $                     .00 
Wage         1.            Total gross wages per Box 5 or Box 18, whichever is greater on Federal Form W-2 
                           (including deferred compensation)                                                   1.  $                     .00 
Information 
             2.            Salary, wages, and other compensation earned outside of Louisville Metro, KY 
                           (Line E)                                                                            2.  $                     .00 
             3.            Salary, wages, and other compensation subject to occupational tax 
                           (Line 1 minus Line 2)                                                               3.  $                     .00 
             Amount of line 3 subject to each tax (See Instructions) 
Occupational 
                             Louisville Metro & Mass Transit (Line 3 x .0145)                      School Board (Line 3 x .0075) 
Tax                                                                                               Louisville Metro Residents Only 
Calculations 4.            A $                                             .00       B  $                                                .00 
Tax Due      5.            Tax Due (Residents: Line 4a + 4b, Non-Residents: Line 4a)                           5.  $                     .00 
             6.            Amount withheld by employer or prepaid                                              6. 
Calculations                                                                                                       $                     .00 
             7.            Balance Due (Line 5 - Line 6)                                                       7.  $                     .00 
             8.            Penalty & Interest (see instructions)                                               8.  $                     .00 
             9.            Total Amount Due (Line 7 + Line 8)                                                  9.  $                     .00 
             10.           Overpayment to be refunded (If Line 6 > Line 5)                                     10. $                     .00 
Non-Resident Must be completed if claiming refund as a non-resident of Louisville, Metro KY. 
             I hereby certify that the address listed below is my permanent home and residence. 
Statement    Address (number and street)                                                                                  Unit /Apt. no. 

             City                                             State                     Zip Code                   Since when 

                               MAILING ADDRESS: P.O. BOX 32060, LOUISVILLE, KENTUCKY 40232-2060 
                                                         Telephone: (502) 574-4860 .  

  Non-Resident   I hereby certify that I am a non-resident, military personnel claiming exemption of my service pay from state and local 
                 taxation under the Soldiers and Sailors Civil Relief Act. The address listed below is my permanent home and residence. 
  military       Address (number and street)                                                              Unit /Apt. no. 
  personnel                                                                                               
                 City                         State      Zip Code                             Since When 
                                                                                              
  Certification  I hereby certify that the information and statements contained herein and any schedules or exhibits attached are true and 
                 correct. 
  Statement      Applicant Signature                                                          Date 
                                                                                              
                 Print Name 
                 
                                              IMPORTANT 
  
  ELECTRONIC FILING: Register for electronic filing. It is an easy, secure, and convenient way to file and pay taxes on-line. For more information log on to 
                                             https://www.metrorevenueservices.org 
  
           Mail Form I-2, along with a copy of Form W-2. If form W-2 is not attached to this tax return a delay will occur if requesting a refund. 

                            MAILING ADDRESS: P.O. BOX 32060, LOUISVILLE, KENTUCKY 40232-2060 
                                             Telephone: (502) 574-4860 .