FORM 543

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

Please fill out all fields. The grey fields are calculated and do not need to be filled out. If the amount of a field is 0, enter a 0.


For the Calendar Year ending December 31, 20

Quarterly Totals


As reported on Form 541Q.




Employee List


(Use Continuation Sheet, Form 543C for additional employees or use W-2 Forms in lieu of 543C)




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Check the button below to acknowledge that you have filled out all required fields and understood the requirements and instructions given for Tax Form 543*