Louisville Metro Revenue Commission 
                                                                                                                        2020
          Occupational License Tax Return                                                                                             OL-3 A 
                                                                                                                                 Form 

 CHECK IF CHANGE IN ADDRESS IS BELOW 

Last name                             First name                                      MI                              Social Security Number 

Address (number and street)                                                   Unit/Apt. no.                                      Account ID 

City, town or post office                               State                 Zip code                                  Tax Year Ending 

Email                                                   Phone no.             Ext.                                     No Activity 
                                                                                                                       Amended Return 
                          Did you make payments in the sum of $600.00 or more to any individual                        Final Return 
 YES      NO            for services rendered in Louisville Metro, Kentucky, other than an                            Business Cease Date 
                          employee? IF YES, YOU ARE REQUIRED TO FILE FORM 1099-SF.                       RETURN STATUS

Income or   1.            Amount of Net Profit per Federal Schedule C (Attach a copy of Schedule C)   1.              $                        .00 
            2.            Add: Occupational taxes deducted on Federal Schedule C                      2. 
(Loss)                                                                                                                $                        .00 
            3.            Add lines 1 and 2. This is your Adjusted Net Profit                       ▶ 3.              $                       .00 
Tax         Do you live in Louisville Metro, Kentucky?               Yes. Complete Section A only     No. Complete Section B only.
            Section A. Residents of Louisville Metro, Kentucky 
Computation 4a.           Adjusted Net Profit per Line 3 above                                        4.              $                        .00 
            5a.           Multiply Line 4, Section A, by (.0220) This is your Tax Due        A        5.              $                       .00 
            6a.           Penalty and Interest (see instructions)                                     6.              $                        .00 
            7a.           Line 5 + Line 6, This is your Amount Due. ▶                                 7.              $                        .00 
            Section B. Non-Residents of Louisville Metro, Kentucky 
            4b.           Adjusted Net Profit per Line 3 above                                        4.              $                        .00 
            5b.           Multiply Line 4, Section B, by (.0145) This is your Tax Due        B        5.              $                        .00 
            6b.           Penalty and Interest (see instructions)                                     6.              $                        .00 
            7b.           Line 5 + Line 6, This is your Amount Due. ▶                                 7.              $                        .00 
Signature   I hereby certify, under penalty of perjury, that the information provided and the attached supporting schedules are true, 
            correct, and complete to the best of my knowledge. 
            Your signature                                                            Date 

            Print/Type your name                                  Your title                          Daytime phone number 

Preparer    Print/Type preparer’s name          Preparer’s signature                  Date            PTIN 
Use Only 
            Firm’s name                       ▶                                                       Firm’s EIN   ▶
            Firm’s address                    ▶                                                       Phone no. ▶ 

                                                               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.metrorevenue.org. 
  Mail Form OL-3A, along with a copy of Federal Schedule C, and a check or money order with your Account ID. The return and payment of taxes due must be 
                            received or postmarked by April 15th to avoid penalties and interest. 

                             MAILING ADDRESS: P.O. BOX 35410, LOUISVILLE, KENTUCKY 40232-5410 
                                                          Telephone: (502) 574-4860