Form Rv-F1308601 - Tennessee Job Tax Credit Business Plan printable pdf download

TENNESSEE DEPARTMENT OF REVENUE

CONTROL NO.

If this is an amended plan, please check the

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box at right; enter original Control No. above

TENNESSEE JOB TAX CREDIT

BUSINESS PLAN

Applicable Credit (Check the box next to the credit for which you are applying):

Standard Job Tax Credit (Minimum investment of $500,000 and at least 25 new qualified jobs)

Enhanced Job Tax Credit per T.C.A. Section 67-4-2109(c)(2)(I)(iii) [Minimum investment of one hundred million dollars

($100,000,000) and at least 100 new qualified jobs.]

Enhanced Job Tax Credit per T.C.A. Section 67-4-2109(c)(2)(I)(ii) [Minimum investment of two hundred fifty million dollars

($250,000,000) and at least 250 new qualified jobs.]

Enhanced Job Tax Credit per T.C.A. Section 67-4-2109(c)(2)(I)(i) [Minimum investment of five hundred million dollars

($500,000,000) and at least 500 new qualified jobs.]

Enhanced Job Tax Credit per T.C.A. Section 67-4-2109(c)(2)(H) [Minimum investment of one billion dollars ($1,000,000,000)

and at least 1,000 new qualified jobs.]

(1) TAXPAYER ________________________________________________________________________________________

(2) TAXPAYER MAILING ADDRESS ________________________________________________________________________

(3) ACCOUNT NUMBER (FEIN) ___________________________________________________________________________

(4) NORTH AMERICAN INDUSTRY CLASSIFICATION SYSTEM CODE (NAICS) ______________________________________

CAPITAL INVESTMENT

(5) AMOUNT

____________________________________________

(6) BEGIN/END DATE ________________

/ __________________

(7) DESCRIPTION OF PRINCIPAL BUSINESS ACTIVITY: _______________________________________________________

_____________________________________________________________________________________________________

(8)

DESCRIPTION OF EXPANSION: ________________________________________________________________________

_____________________________________________________________________________________________________

NEWLY CREATED TENNESSEE JOBS

FISCAL YEAR END

TENN. JOB INCREASE

TOTAL TENN. JOBS

COUNTY

(9)

__________________

___________________

__________________

(10)

__________________

___________________

__________________

(11)

__________________

___________________

__________________

FOR DEPARTMENT USE ONLY

(12) THE STATEMENTS MADE ON THIS BUSINESS PLAN ARE TRUE TO THE BEST OF MY

KNOWLEDGE AND BELIEF. (THIS BUSINESS PLAN MUST BE SIGNED BY THE TAX-

PA YER.)

SIGN

HERE

Department of Revenue Delegate

Taxpayer Signature (Do not print or use stamp.)

Title

Date

Phone No.

Date

RV-F1308601 (Rev. 8-05)

INTERNET (1-07)

Form Rv-F1308601 - Tennessee Job Tax Credit Business Plan

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