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
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