Employer-Assisted Day Care Tax Credit Worksheet For Tax Year 2006

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EMPLOYER-ASSISTED DAY CARE TAX CREDIT
WORKSHEET FOR TAX YEAR 2006
36 M.R.S.A. § 5217
TAXPAYER NAME: _____________________________________ EIN/SSN: ________________
Note: Owners of pass-through entities (partnerships, LLCs, S corporations, trusts, etc.) making an eligible
investment, see instructions. Also, please provide name and ID number of the pass-through entity on the
lines below.
NAME OF PASS-THROUGH ENTITY
EIN/SSN
________________________________________________________________
____________________________
1.
Number of employees’ children enrolled full-time (or number of full-time equivalents
for all enrolled children) in day care services provided/paid for by the employer in
2006 (See instructions) ....................................................................................................1. _____________________
2.
Line 1 x $100 ...................................................................................................................2. _____________________
3.
Actual costs incurred by employer in providing day-care services for children of its
employees for the taxable year ........................................................................................3. _____________________
4.
Line 3 x 20% (0.20) ..........................................................................................................4. _____________________
5.
Enter the lesser of line 2, line 4 or $5,000 .......................................................................5. _____________________
6.
Do any of the day care services provided in 2006 qualify as “quality child-care”
services? ............................................................................................................................
Yes
No
See instructions. If yes, enter the certifi cate number(s) ________________________
of the quality child-care certifi cate(s) issued to the facility by the Department of
Health and Human Services, Offi ce of Child Care and Head Start.
Enter credit amount from line 5 that relates to amounts paid for quality child-care
services ............................................................................................................................6. _____________________
7.
Line 6 x 2 .........................................................................................................................7. _____________________
8.
Line 5 minus line 6 (not less than zero) ...........................................................................8. _____________________
9.
Current year credit amount (line 7 plus line 8) .................................................................9. _____________________
10. Credit carried forward/back from other tax years. See instructions ...............................10. _____________________
11. Total credit available this year (line 9 plus line 10). Corporate taxpayers, enter this
amount on Form 1120ME, Schedule C, line 29c. Individuals, enter this amount on
Form 1040ME, Schedule A, line 10 ............................................................................... 11. _____________________
Rev. 11/06

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