Fillable Form 1.: BALANCE DUE 12.00% 2. 3. 4. (McCracken County Fiscal Court)

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Form 1.: BALANCE DUE 12.00% 2. 3. 4. (McCracken County Fiscal Court)

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EMPLOYER'S QUARTERLY RETURN OF LICENSE FEE WITHHELD
If no wages were paid this period, mark "NONE" and return this form
MCCRACKEN COUNTY TAX ADMINISTRATOR
$ _______________
Total earnings paid all employees in quarter within
McCracken County.
$ _______________
Account No.
FOR PERIOD ENDING
Month Day Year
Make check payable and
mail to:
*PLEASE MAKE A COPY OF THIS FORM FOR YOUR RECORDS.
Less earnings for work or services rendered in City of
Paducah only.
Taxable Balance - Line 1 Less Line 2
Penalty per calendar month
$ _______________
MCCRACKEN COUNTY TAX
ADMINISTRATOR
(270) 444-4722
Form OCC-3PT Rev. 1/22/2010
BALANCE DUE
$ _______________
RETURN DUE ON OR BEFORE
Month Day Year
I hereby certify that the information, schedules, statements and exhibits filed
herewith are true and correct.
Signed _____________________________________________________
OfficialTitle ________________________________ Date ___________
Indicate any name or address change above.
FED ID No.
Number of Taxable Employees
$ _______________
_______________
1.00%
Phone:
1.
2.
3.
4.
5.
6.
7.
Interest (per month) 1.00%
$ _______________
Fax:
(270) 444-4737
TAX DUE AT:
12.00%
$ _______________
5.00%
(not less than $25.00)
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Form 1.: BALANCE DUE 12.00% 2. 3. 4. (McCracken County Fiscal Court)

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Completed 18 July 2020

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