North Dakota Offi ce of State Tax Commissioner
Ag commodity processing facility investment reporting form
This form is for reporting investments made in tax years beginning on or after January 1, 2007—see instructions.
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This form must be completed by the qualifi ed business.
Investment information
Date of investment ►
Amount of investment ►
Type of investor:
Individual
Partnership
“C” Corporation
“S” corporation
Estate or trust
Social security
Name of investor ______________________________________
number or FEIN _______________________
Spouse’s name,
Spouse’s social
if joint investment _____________________________________
security number _______________________
Address __________________________________ City __________________ State _______ ZIP _____________
Qualifi ed business
Name of qualifi ed business _________________________________________
FEIN ______________________
Signature of authorized representative ________________________________
Date ______________________
Printed name of authorized representative _____________________________
General instructions
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If an eligible taxpayer is a passthrough
It is made within the certifi cation
entity—partnership, S corporation, or
period specifi ed in the certifi cation
This form must be used by a qualifi ed
limited liability company treated like a
confi rmation letter issued to the
business to report the receipt of a
partnership or S corporation—the tax
qualifi ed business by the North Dakota
qualifi ed investment from an eligible
credit is calculated at the passthrough
Commerce Department.
taxpayer for purposes of the agricultural
entity level and passed through to its
commodity processing facility investment
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It is at risk in the qualifi ed business. An
owners.
tax credit under N.D.C.C. ch. 57-38.6.
investment is at risk when it is available
Date of investment—For a qualifi ed
to the qualifi ed business for its use.
Important: Unless otherwise provided
investment of cash, the “date of
Monies placed in escrow are not at risk.
by a change in law, these instructions
investment” means the date on which the
The investment must remain at risk
only apply to investments made by
cash is received and is available for use
for at least three years from the date
eligible taxpayers in tax years beginning
by the qualifi ed business. For a qualifi ed
of investment to maintain its qualifi ed
on or after January 1, 2007. For this
investment of a fee simple interest in real
status.
purpose, the tax year of the eligible
property, the “date of investment” is the
taxpayer (investor) is used, not that of the
An individual who is a participant in a
date on which the instrument transferring
qualifi ed business.
retirement plan is deemed to have made
title is recorded as provided under
a qualifi ed investment in the case of a
For purposes of investments reported on
N.D.C.C. ch. 47-19. The taxpayer’s tax
direct transfer (by the trustee) of monies
this form, the following defi nitions apply:
year in which the date of investment falls
from the retirement plan to a qualifi ed
is the fi rst tax year in which the tax credit
Qualifi ed investment—A “qualifi ed
business if (1) a separate retirement
is to be used.
investment” means one that meets all of
plan account is maintained for the
the following conditions:
individual, (2) the monies come out of
Specifi c instructions for
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the individual’s account, and (3) the
It is made by an eligible taxpayer—see
individual controls where the account’s
the qualifi ed business
“Eligible taxpayer” below.
assets are invested.
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Use this form only if you have been
It is in the form of a cash payment or
certifi ed by the North Dakota Commerce
Eligible taxpayer— An “eligible
the transfer of a fee simple interest
Department’s Division of Economic
taxpayer” means an individual, estate,
in real property located in North
Development and Finance as a qualifi ed
trust, partnership, corporation (“C”
Dakota. For a fee simple interest
business for purposes of the agricultural
or “S”), or limited liability company.
in real property, see N.D.C.C.
commodity processing facility investment
An eligible taxpayer does not include
§§ 57-38.6-01(5) and 57-38.6-03(8) for
tax credit program under N.D.C.C.
a government entity or a tax-exempt
all of the requirements.
ch. 57-38.6. This will be evidenced
organization; however, this does
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It is made to acquire an equity interest
by your receipt of a letter from the
not preclude either from making an
or a right to receive a dividend
Commerce Department confi rming
investment in a qualifi ed company for
payment.
the certifi cation and setting out the
which a tax credit is not allowed.
certifi cation period.
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