Form 41a720-S42 - Schedule Keoz-T - Tracking Schedule For A Keoz Project - 2006
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SCHEDULE KEOZ-T
➤ See instructions.
41A720-S42 (10-06)
Commonwealth of Kentucky
DEPARTMENT OF REVENUE
T
S
RACKING
CHEDULE
F
A K
P
OR
EOZ
ROJECT
➤ Attach a copy of this schedule
to Schedule KEOZ or KEOZ-SP.
KRS 154.23-050 to 079
Name of
Corporation as defined in KRS 141.010(24)
Federal Identification Number
Kentucky Account Number
General Partnership
Other ___________________________________________________
_ _
_ _ _ _ _ _ _
_ _ _ _ _ _
—
Location of Project
Activation Date
Economic Development
KEOZ Agreement
Project Number
_ _ / _ _ / _ _
City
County
Mo.
Day
Yr.
Check One:
Service or Technology Agreement
Tax Incentive Agreement
Note that Columns B and C apply only to service or technology agreements and Columns D and E apply only to tax
incentive agreements.
A
B
C
D
E
F
G
H
Excess
50 Percent
Taxable
Employee Wage
Debt Service
Balance of
Debt
KEOZ Tax
KEOZ Tax
of Approved
Year
Assessment Fees
Payment
Approved Costs
Service Payment
Credit Limitation
Credit Claimed
Annual Rental
Ended
Withheld
(Col. G–Col. H)
Payments
from Prior Year)
+
–
=
+
+
–
=
+
+
–
=
+
+
–
=
+
+
–
=
+
+
–
=
+
+
–
=
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