Due Date: April 15 or 15
th
day of fourth month following close of Fiscal Year
Extension Date: October 15
1 Revised: November 2019
City of Morgantown
Net Profit License Fee Return
1. Business Information:
Name of Business:
City of Morgantown Account Number:
Job Site or Business Address within City Limits (Physical Address Only):
Accounting Period per Federal Return: (Choose One)
⃝ Calendar Year: Year: ____________ Dates: Beginning: ____________ Ending: ___________
⃝ Fiscal Year: Year: _______________ Dates: Beginning: ____________ Ending: __________
2. Complete Schedule A, B, and C on Page 2.
2A. Industrial businesses with 50+ full-time employees located on an industrial-zoned lot are exempt from Net Profit License
Fees. Complete this section and skip to Section 5. (Federal W-2s and W3 form are required for verification)
Total Number of employees: ____________
Physical address of Business: ________________________________________________________________
3. Balance due from Line C5 of SCHEDULE C: $ .
3A. Extensions: The City may grant a business entity any extension up to six months, unless a longer extension has been
granted by the Internal Revenue Service. The business entity must provide an estimated tax payment and provide a copy of
the federal extension. If approved, the business entity shall pay an amount equal to twelve percent (12%) per annum
simple interest on the tax shown due on the report from the time the tax was due until the return is filed and tax paid. A
fraction of a month is counted as an entire month.
Requested Extension date: Estimated Payment Amount:
4. Statement of Responsibility
I, the undersigned, being the president, vice president, secretary, treasurer or any other person holding an equivalent
position of this business entity subject to Ordinance 2008-05 understand that I shall be personally and individually liable,
both jointly and severally, for any tax required to be withheld from compensation paid to one or more employees of this
business entity, and neither the corporate dissolution or withdrawal of the business entity from the City, nor the cessation
of holding any corporate office, shall discharge the liability of any person; provided that the personal and individual
liability shall apply to each or every person holding the corporate office at the time the tax becomes or became obligated.
I further understand that no person shall be personally and individually liable under this subsection who had no authority
to collect, truthfully account for, or pay over any tax imposed by Ordinance 2008-05 at the time the taxes imposed by this
ordinance become or became due.
5. Signature of Responsible Party:
Full Legal Name (Print): Phone:
Email:
Signature: Date:
Submit this form, a copy of your IRS Tax Return for this income and a check or money order payable to:
City of Morgantown
PO Box 397
Morgantown, KY 42261
