Biotechnology Exclusion Worksheet - San Francisco printable pdf download

CITY AND COUNTY OF SAN FRANCISCO

Cert #___________

Office of the Treasurer & Tax Collector

Business Tax Section

Biotechnology Exclusion Worksheet for Payroll Tax Year 20__

Qualifying for the Biotechnology Exclusion

The biotechnology exclusion applies to all San Francisco Businesses that engage in Biotechnology enterprises. To qualify the business must be

engaged in business operations that use cell fusion, recombinant DNA and bioprocesses. For purposes of this exclusion, “bioprocesses” means a

process that alters the genome of an organism.

Employees for which the exclusion may be claimed include any employee whose work is substantially in support of the taxpayer’s biotechnology

business. If your business qualifies as a biotechnology business and also engages in other non-biotechnology business enterprises, then the

compensation paid to employees that do not spend at least 50% of their time in support of the biotechnology business do not qualify for the exclusion.

(Please print neatly or type using black ink. Worksheet must be signed to be valid.)

Section 1: Business Information

Enter Federal Employer Identification number:

Enter Business Tax Certificate number:

Enter name of business:

Enter principal San Francisco business location: (Street address)

Does your company engage in biotechnology business in more than one location in San Francisco? Circle one.

Yes

If yes, list each location address below:

(a)

(b)

Does your company combine DNA segments in a plasmid to create new organisms?

Does your company operate a lab for biotech research and experimental development?

Section 2: Payroll Tax Exemption Information

Enter total number of employees:

Enter total number of employees working outside of San Francisco:

10.

Enter total Payroll Expense paid to employees in Line 9:

Section 3: Biotechnology Exclusion Information

11.

Enter total number of San Francisco employees:

12.

Enter total number of San Francisco employees for which the Biotechnology Exclusion is being claimed:

13.

Enter total Payroll Expense paid to employees in Line 13:

Section 4: Calculation of Total Exclusion

14.

Enter the sum of Lines 10 and 13 above. Enter this amount also on your Payroll Tax Statement (Long Form),

Line 2. Attach this worksheet to your Payroll Tax statement and file both by the Payroll Tax deadline.

I understand that the facts supporting my application for the Biotechnology Exclusion, as set forth on this worksheet, are subject to audit by the San

Francisco Tax Collector. Under the laws of the State of California, I declare under penalty of perjury that I have read the foregoing and that it is true,

correct, and complete to the best of my knowledge and belief.

Sign:

Date: _____/_____/_____

Print Name:

Contact Number: (

)

________

Title:

Fax Number: (

)

For questions, please contact Taxpayer Assistance at (415) 554-4400.

Biotechnology Exclusion