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Form Ct-1120 Hic - Hiring Incentive Tax Credit - State Of Connecticut Department Of Revenue Services 2001

2001

STATE OF CONNECTICUT

FORM CT-1120 HIC

DEPARTMENT OF REVENUE SERVICES

Hiring Incentive Tax Credit

(Rev. 12/01)

FOR INCOME YEAR

Beginning

2001, and Ending

CT TAX REGISTRATION NUMBER

Corporation Name

0 0 0

PURPOSE OF FORM

Complete Form CT-1120 HIC, Hiring Incentive Tax Credit, to claim the credit available for hiring a qualifying employee. (Conn. Gen. Stat.

§12-217y)

DEFINITIONS

A qualifying employee is any employee who, upon the initial hiring of such employee is employed not less than 30 hours per week for a full

calendar month by the same business firm and who, at the time of being hired, is and has been receiving benefits from the temporary family

assistance program for more than nine consecutive months immediately preceding the date of employment. (Conn. Agencies Regs.

§12-217y-1(9)). The number of hours per week an employee participates in a job training program approved by the Commissioner of the

Connecticut Department of Labor (CTDOL) shall be included in calculating the number of hours the employee works.

CREDIT COMPUTATION

Multiply the number of full calendar months worked by qualifying employees during the income year by $125 to determine the amount of

credit.

This form must be accompanied by an approval letter issued by CTDOL. For further information contact CTDOL, Program Support Unit,

200 Folly Brook Boulevard, Wethersfield CT 06109-1114, 860-263-6030, or see Informational Publication 2001(17), Guide to Connecticut

Business Tax Credits.

— This form must be attached to Form CT-1120K —

PART I - CREDIT COMPUTATION (If additional lines are needed, attach a worksheet)

Qualifying Employee Name

Employee Social

Date of Hire

Number of Full

Column D

Security Number

Calendar Months

Multiplied by $125

E m p l o y e d

10.

11.

Tax Credit: Add Lines 1 through 10, Column E. Enter here and on Form CT-1120K, Part I-D, Line 16, Column A.

NOTE: For credit carryforward instructions and schedule, see Part II on reverse side of this form.

Form Ct-1120 Hic - Hiring Incentive Tax Credit - State Of Connecticut Department Of Revenue Services 2001