Due Dates: April 30, July 31, October 31, January 31
City of Morgantown
Occupational Tax Return
Year:
Quarter Ending: ⃝ March 31 ⃝ June 30 ⃝ September 30 ⃝ December 31
Business Information:
Name of Business: Phone:
Business Address: E-mail:
City, State, and Zip: Fax:
If this business is no longer in operation, please provide the date operation was terminated:
Full-time employees: Part-time employees: Total # of employees: __
How many employees do you employ through temp services: ______
1. Total Gross Salaries, Wages,
Commissions, and Other
Compensation Paid: $
2. Less Compensation Paid
for Services Outside
Morgantown: ( )
3. Taxable Earnings
in Morgantown: $
4. Actual Tax Due in
Quarter at 2%: $
5. Interest 12% Annum
after Due Date: $
6. Penalty*: $
7. Total Taxes Due Including
Interest & Penalty: $
*PENALTY: After (30) days from due date, 5% per month, not to exceed 25%. Minimum penalty amount $50.
If no wages were paid this quarter, mark “none” on line 7 and return this form with explanation. Notify City of
Morgantown of any change in ownership.
Signature Title Date
I hereby certify, under penalty of perjury, that the statements made herein and in any supporting
schedules are true, correct and complete to the best of my knowledge.
• A copy of this form must accompany your payment. You should retain a copy for your records.
• The employer must file with the City a copy of the employees W-2 Wage Tax Statement and any 1099s for
services performed during the calendar year on or before the last day of February each year.
• This return must be filed whether or not you had employees during this period.
• All businesses receiving this form MUST return a form. A $50 late filing fee will be applied to any forms filed
after the due date.
Payment should be made payable to:
City of Morgantown, KY
PO Box 397
Morgantown, KY 42261
Contact information:
t.evans@morgantownky.gov
Phone: (270)526-3557
Fax: (270)526-6295
