CITY OF ASHLAND 
Department of Finance
Occupational License / Net Profit Division
P.O. Box 1839, Ashland, KY 41105-1839
Phone No.  606/327-2013, 2014, or 2023  Fax No.  606/324-0978

                                                                      CITY OF ASHLAND
                                                                  NET PROFIT LICENSE FEE RETURN

For Year Ended                                                    BUSINESS NAME

                                                                  NUMBER & STREET

          Due Date                                                CITY                                            STATE                     ZIP                  PHONE
15th day of the fourth month 
following close of the year.                                      TRADE NAME, IF ANY                                                                 NATURE OF BUSINESS                     

Type of Business:
                                                                  1.  Net Profit / Income per attached Federal Return
o   Corporation          
o   Partnership                                                   2.  Add: Items Not Deductible (Line 4, Schedule A on Back)
o   Sole Proprietor
o   Other                                    .                    3.  Adjusted Net Profit (Line 1 plus Line 2)

                                                                  4.  Ashland Percentage (From Schedule B on Back)
Federal ID or Social Security No.
                                                                  5.  Net Profit Subject to License Fee (Line 3 multiplied by Line 4)

                                                                  6.  License Fee Due (2.0% of Line 5)
ATTACH A COPY OF THE
APPLICABLE FEDERAL                                                7.
                                                                      Annual Business License Fee
RETURN OR SCHEDULE
                                                                  8.  Enter the larger of Line 6 or Line 7
FED. SCH. C or E (1040)
FED. 1041, 1065 or 1120                                           9.  Total Estimated Payments (including annual business license fee) 
                                                                      and Prior Credits
                                                                  10. Refund or Credit. If Line 9 is greater than Line 8, Enter the 
Please note: Federal return should include                            difference. (Circle Refund or Credit)
Cost of Goods Sold Schedule and/or                                11. Balance Due. If Line 8 is greater than Line 9,                                         
Other Schedules                                                       Enter the difference.
                                                                  12. Penalty (5% per month if filed after due date  -  minimum $25)

                                                                  13. Interest (12% per annum until paid)
ALL 1099 FORMS ISSUED 
MUST BE ATTACHED                                                  14. Total Amount Due (add Lines 11,12 and 13)

                         I hereby certify that the statements made herein and in any supporting schedules
                                                                  are true, correct and complete to the best of my knowledge.

          Authorized Signature                                                                       Title                                                              Date

                                                                  IF PAYING BY MASTERCARD OR VISA, COMPLETE BELOW
                                                                                                                                                                          SIGNATURE
                                                                  CARD NUMBER
                   ( )  MASTERCARD                        ( ) VISA
                                                                  AMOUNT                                                                                          EXP DATE

                                                                      FOR INTERNAL USE ONLY

Reconciled                                                                                                                                                                                                           By:    Date:

                           SCHEDULE A

                           ITEMS NOT DEDUCTIBLE
1. Taxes based on income

2. City of Ashland license fees

3. Net operating-loss deduction

4. Total not deductible

                           SCHEDULE B

COMPUTATION OF PERCENTAGE OF NET PROFITS SUBJECT TO LICENSE FEE
                               (A)                                                      (B)                                        (C)                                           
ALLOCATION FACTOR              ASHLAND         TOTAL                                    ASHLAND                                                     
                               FACTOR          EVERYWHERE                               PERCENT

1.  Gross Sales or Receipts