CALENDAR
Form E-234                                   CITY OF ST. LOUIS               YEAR
(Rev. 11/16)
                                   EARNINGS TAX RETURN

TAXABLE YEAR BEGINNING                                          AND ENDING                                                                  FOR OFFICE USE ONLY
TYPE OF RETURN:                                     DAYTIME TELEPHONE #:
   E-2 INDIVIDUAL (LLC, 1099-Misc., Schedule C)                                                             FEIN OR SSN #:  
   E-3 PARTNERSHIP (LLC, Trust)                                              PRINCIPAL BUSINESS ACTIVITY:
   E-4 CORPORATION (LLC, Sub S or C)                                                                                             E-MAIL:

                                                                                                                        Check applicable boxes: (1)        Due month change
                                                                                                                        (2)             Amended return (3) Change in address
                                                                                                                        (4)             Account terminated
                                                                                                            DATE & REASON (REQUIRED):
             
                                                                                                            TO WHOM SOLD OR TRANSFERRED:

                                                                                                            ADDRESS OF NEW OWNER:

                                                                                                                                 VERIFIED BY               AUDITED BY 
PLEASE PRINT YOUR NAME AND ADDRESS IN THE SPACE ABOVE IF NOT ALREADY PROVIDED.
               Please see the instruction sheet for additional information.
                                                    SECTION A - NET PROFIT                                                                        ROUND TO NEAREST WHOLE DOLLAR
1. Gross Receipts or Transactions (less Returns and Allowances)                                                                         1.
2. Cost of Goods Sold (attach itemized list)                                                                                            2.
3. Gross Profit (subtract line 2 from line 1)                                                                                           3.
4. Other Income or Loss (attach itemized list)                                                                                          4.
5. Total Gross Profit (add lines 3 and 4)                                                                                               5.
6. Business Expenses (use Section A-1 on the reverse side)                                                                              6.
7. Net Profit or Loss (subtract line 6 from line 5)                                                                                     7.
                     SECTION B - NET PROFIT BY ALLOCATION (From Section B Worksheet, on back)
8. (a) Allocation percent (line 2)                                                                                                      8a.                             %
   (b) Net Profit by allocation (line 7 multiplied by line 8a)                                                                          8b.
                                               SECTION C - COMPUTATION OF TAX
9. Taxable Net Profit (line 7, line 8b or total of column 3 in Section B-1)                                                             9.
10. Earnings Tax Due is 1% of line 9 (no tax due if less than $1.00)                                                                    10.
11. Payroll Expense Tax Credit (complete Section C-1 on the reverse side)                                                               11.
12. Net Earnings Tax Due (line 10 minus line 11)                                                                                        12.
13. Less Extension payment and pre-payments (penalty and interest will be assessed if prepayment is not 90% of tax due)                 13.
14. Subtotal (line 12 minus line 13)                                                                                                    14.
15. Penalty                     %                                                                                                       15.
16. Interest                     %                                                                                                      16.
17. Amount Due                                                                                                                          17.
18. Amount Overpaid.               Refund or  Carry Forward (refund claims under $1.00 will not be awarded)                             18.
Pursuant to the Revised Code of the City of St. Louis, § 5.22.100, the Collector of Revenue or his duly authorized agent has the                  The City of St. Louis requires
authority to audit the facilities or tax returns of an employer or taxpayer. I declare this return has been examined by me and is true, 
correct and complete to the best of my knowledge and belief.                                                                                      all extension requests to be
                                                                                                                                                  filed on Form E-8 (see
                                                                                                                                                  instructions). An estimated
   (Date)                                           (Signature)              (Typed or Printed Name)                                      (Title) payment of 100% of the tax
                                                                                                                                                  due is required with your  
                                                                                                                                                  extension request.
   (Signature of preparer other than taxpayer)      (FEIN/SSN of preparer)   (Address, City, State, Zip)

             (Preparer Telephone #)                                          (E-Mail Address)
                                                                                                                        Please mail all returns and payments to:
                                                                                                                        GREGORY F.X. DALY
   WEBSITE: www.stlouiscollector.com                                                                                    COLLECTOR OF REVENUE
                                                                                                                        1200 MARKET STREET, ROOM 410
                                                                                                                        ST. LOUIS, MO 63103-2841
                                             Telephone: (314) 622-4248
                                                    Fax: (314) 622-4847

                                                          SECTION A-1 - BUSINESS EXPENSE DEDUCTIONS 
                           ITEM                              AMOUNT                                ITEM                              AMOUNT
1. Car and Truck Expense                                                      8. Rent
2. Commissions                                                                9. Repairs
3. Depreciation                                                               10. Taxes (Except Federal, State and
                                                                              Local Income Taxes)
4. Dues and Publications                                                      11. Utilities and Telephone
5. Insurance                                                                  12. Wages and Salaries
6. Legal and Professional                                                     13. Other Deductions (itemized list required)
7. Office Expense and Supplies                                                        Total–Enteronline 6,SectionA
                                   SECTION A-2 - INFORMATIONAL DISBURSEMENT (Print N/A if Not Applicable) 
                                TO WHOM PAID                                                              Total Amount               Amount or
                                                                                        FEIN/SSN                  Paid               Percent Earned
   Name                    Address                           City, State, Zip                                                        Within the City

(Please attach additional sheets or 1099-Misc. as necessary.)
                                   SECTION B WORKSHEET - BUSINESS ALLOCATION OF TAXABLE NET PROFIT 
                Allapplicablefieldsmustbecompleted.                           Within & Without            Within                     Percentage Within 
                Pleaseattachalistofallbusinesslocations.                      St. Louis                   St. Louis                  St. Louis
1. (a) Average Value of Real and Tangible Personal
     Property, including inventory.

   (b) Gross Receipts

   (c) Wages & Salaries (except Officers) 

                                                                                                         Total Percentage %
2. ALLOCATION PERCENTAGE:
   Total of Percentages divided by number of factors used                               %. Enter this percent on line 8a. Section B. 
                                                          SECTION B-1–PARTNER’SSHAREOF NETPROFIT
Non-residentpartnersusetheallocation%from Section B.Partnerswhoare residentsofSt.Louisaresubjecttotaxontheir full
shareof thenet profitandcannotallocate.
                                                                                        Share of          Allocation                 Taxable
                                List Partners Below                                     Net Profit        Percentage                 Income
Name                                      FEIN/SSN
Home Address                                                 Zip
Name                                      FEIN/SSN
Home Address                                                 Zip

(Attach list if necessary)                                                    Entertotal“TaxableIncome” online9,Section C

                                                          SECTION C-1–PAYROLLEXPENSETAX CREDIT
     1.      Did you pay the Payroll Expense Tax on Form P-10?                                            No (P-10 credit does not apply)
     2.      Total quarterly Payroll Expense Tax paid from line 3, Form P-10.
                st                 nd                           rd                    th
             1  Qtr.               + 2    Qtr.               + 3 Qtr.         + 4       Qtr.             =
     3.

     4.      Tax amount due from line 10, Section C (reverse side)

     5.      Smaller of lines 3 and 4 (Please enter this amount on line 11, Section C)