CITY OF MURRAY                                                        PRINT 
                                                      Mailing Address: City of Murray
                                                           Attn: Occupational Tax
                                                                P.O. Box 1056          
                                                           Murray, KY 42071
                                                Telephone (270) 762-0300 - www.murrayky.gov                                       FORM
                                                                                                                             OCC 1

                   OCCUPATIONAL LICENSE TAX      APPLICATION 

 In accordance with City of Murray Ordinance 2017-1743, Chapter 75, any employee performing work and 
 rendering services to an employer or business entity within the City limits shall be assessed a 1% Occupational Tax 
 on gross earnings.  Please complete and remit this form as directed.  

If individual taxpayer, see page 2 section 2 for definition of individuals and if applicable, complete sections 
                                             2 and 3 and disregard section 1.   
If employer with employees earning wages for  work performed or services rendered within the limits of the City 
                           of Murray, please complete Sections 1 and 3 and disregard Section 2. 

                                                                  Section 1 
Legal Name: _____________________________________________________________________ __________ Phone: _____           _______________________________      
Business Operating Name (DBA):_________________________________________________________________________________________________________ 
Owner(s)/CEO:________________________________________________________________________________ Email:__________________________________ 
Business Address: __________________________________________________________________________________On-Site Manager:     ______________________ 
City:_____________________________________________________ State: _______ Zip: ______________ Is this address a Residence? ____Yes  ____No 

Mailing Address: ____________________________________________ City: _______________________ State: _____ Zip: _____________ 
Check Ownership Type: ____Sole Proprietor ____Partnership ____Corporation ____LLC ____LLP   ____ Federal 

Business Identification # (Tax ID#, EIN, or last 6 SSN): * __________________________      NAIC #___________________ 
 *  A separate application is needed for all businesses that operate under the above business identification number.

If Non-Profit, Tax Exempt # ______________________       
Emergency Contact Name: __________________________________________________ Phone#: ________________________ 

   Accounting Period     : Calendar Year______      Fiscal Year______   Please specify beginning of year__________________                 

Do you  have W2 employees working in Murray?   Yes_____      No_____    Estimated number of W2 employees?  ____                   ____       _ 

If yes, under what company name is payroll paid?  ________________________________________________________ 

Do you have 1099 non-employees working within the city limits of Murray?Yes_____       No_____(If so please attach a copy of 1099’s) 

Estimated number of 1099 Employees ____ ____ If you are a general contractor will you be using subcontractors?  Yes_ __No__            _ 

If you answered yes, you must provide a list of subcontracters ot the City of Murray.

Murray location(s) and phone number if different from above  __________     _______________________________________             

Do you lease the property where the business is located?  Yes_____     No_____ 

If yes, provide Owner’s name ________________________________________  Phone number                      _________________________ 

                                                            Page 1 of 2

                                                                                                                               FORM
                                                                                                                               OCC 1
                                                                                                                                              
The City of Murray    imposesan occupational tax of 1% of all gross earnings paid for work performed and services renderedwithin     the 
limits of the City of Murray. This applies to every resident and non-resident who works within the limits of the City of Murray. It is 
the responsibility of each employer to withhold these fees and submit them on the required periodic basis. Employers who fail to 
withhold or pay the withholding to the City shall be personally liable to the City for any sums withheld or required to be withheld.  
Please indicate name, address, phone number of the person responsible for calculating withholding and remitting the occupational tax: 
Name_____________________________________________________________________________________________ 

Address___________________________________________________________________________________________ 

Phone Number_____________________________________________________________________________________ 

**PLEASE NOTE**  It is the applicant’s responsibility to inform the City of Murray of any changes in ownership, 
addresses, number of employees or termination of business activity.  The undersigned (business) agrees to be 
responsible for all collection costs and attorney’s fees in connection with any delinquent account.  
***If this is a first time submittal of an Occupational Tax Application, please include a check for a one-time $25.00 fee*** 

                                                                    Section 2 
                                               Individual taxpayer and Federal employee
    This section applies to individual tax payers and federal employees who receive W2 wages for work performed and services 
            rendered within the limits of the City of Murray where the Employer is not required to withhold, report or remit.

    Individual Name:  __________________________    ____ Phone: ___________________ Email:_________________________________  

    Address: __________________________________________ City: _________________________ State: _____ Zip: __________ 

    Employer Name:______________________________________________       Phone: ___________________  

    Address: ___________________________________________  City: ___________ State: _______ Zip: ______________      

Taxpayer    Type: ____Sole Individual   ____   Federal Business Identification # (last 6 SSN): * __________________________ 

    _________________________________________________________________________________________________________ 

    *A separate application is needed for all businesses that operate under the above business identification number.

                                                                Section 3 
    I declare under penalty of perjury that the above application is true and correct to the best of my knowledge. I certify that I will 
    operate my business in accordance with all applicable federal, state, and city laws and regulations and permit enforcement authority 
    onto business property of such laws and regulations. 

    Signature: __________________________________________ Title: ________________________ Date: _________________ 

                                                       OFFICIAL USE ONLY 
    Business License #: _______________       Occupational License Tax #: _____________________   Rec’d by ___________________________ 

    Comments:  __________________________________________________________________________________________________________ 

                                                       Page 2 of 2