FORM 541Q


City of Lebanon, Kentucky
240 West Main Street/P.O. Box 840
Lebanon, Kentucky 40033

Employer's Quarterly Return:
Occupational License Fee Withheld


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The grey fields are calculated for you and do not need to be filled out.
If the amount of a field is 0, enter a 0.Your total amount will appear once all possible fields have been filled out.
















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Summary of Monthly Payments




Date and Amount of Payment 1

Date and Amount of Payment 2

Date and Amount of Payment 3

Date and Amount of Payment 4

Date and Amount of Payment 5

Date and Amount of Payment 6



Employer Information











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Instructions


The return is for a period of three calendar months ended March 31, June 30, or December 31 and is due on, or before the last day of the month, following the end of the quarter. More detailed information for employers may be obtained from the Tax Administrator, City of Lebanon, P.O. Box 840, Lebanon, KY 40033


Line 1: Enter total compensation paid during the quarter, regardless of when or where earned.

Line 2: Enter the amount included in line 1 which represents payment for services performed or work done outside Lebanon. The employer must maintain adequate records to substantiate this amount.

Line 5: See instructions on Form 501 for monthly payment requirement. Summarize monthly payments (if required) made this quarter in item 11: transfer total to line 5

Line 7: A penalty of 5% is imposed for each month or fraction thereof after the due date of the return during which the license fee remains unpaid

Line 8: Interest accrues on unpaid license fees at a rate of 12% per annum from the due date of the return until paid


If you prefer to pay by mail,
you may send a check or money order to:
PO Box 840 Lebanon KY 40033