Form R-1086 - Solar Energy Income Tax Credit For Individuals And Businesses - 2014 Page 5
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5R-1086-B (Page 4) (1/15)
Declaration by Residential Property Owner not Claiming
the Solar Energy Income Tax Credit
This page is only to be signed by the owner of a residential property who does not own a solar energy system after it is installed on the
residential property. LAC 61:I.1907(E)(10)(j) provides that “when a system is installed by a third party owner, a complete and signed fourth
page of Form R-1086” is required. This page should be included with Form R-1086 by the third party owner of the energy system who is
claiming the credit.
PLEASE PRINT OR TYPE.
Residential Property Where the Solar Energy System was Installed
Address
City
State
ZIP
LA
Wind or Solar Energy System Information
Solar Electric System
Solar Thermal System
Date the installation of the energy system was completed __________________ (mm/dd/yyyy) in a Louisiana residence.
Contractor’s Name
Contractor’s Louisiana License Number
Declaration
The owner\Co-owner of the residential property located at the address shown above hereby declares that the owner/ co-owner
transfers the right to obtain the credit to the third party lessor, and will not claim, a Louisiana income tax credit for the solar energy
system described above.
Name of Residential Property Co-owner
Signature of Residential Property Owner, Officer of Owner Entity or Other
Date
(mm/dd/yyyy)
(for other attach power of attorney)
If the residential property is owned by more than one person\entity, all additional co-owners must sign the Declaration on the spaces
provided below. Attach additional sheets if necessary.
Declaration
Co-owner of the residential property located at the address shown above hereby declares that the owner/ co-owner transfers the right to
obtain the credit to the third party lessor, and will not claim, a Louisiana income tax credit for the solar energy system described above.
Name of Residential Property Co-owner
Signature of Residential Property Owner, Officer of Owner Entity or Other
Date
(mm/dd/yyyy)
(for other attach power of attorney)
Declaration
Co-owner of the residential property located at the address shown above hereby declares that the owner/ co-owner transfers the right to
obtain the credit to the third party lessor, and will not claim, a Louisiana income tax credit for the solar energy system described above.
Name of Residential Property Co-owner
Signature of Residential Property Owner, Officer of Owner Entity or Other
Date
(for other attach power of attorney)
(mm/dd/yyyy)
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