Form 8874-A - Notice Of Qualified Equity Investment For New Markets Credit Form

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8874-A
Notice of Qualified Equity Investment for
Form
New Markets Credit
OMB No. 1545-2065
(Rev. December 2011)
Department of the Treasury
Internal Revenue Service
1
Name of qualified community development entity (CDE)
2
EIN of qualified CDE
3
If applicable, name of parent taxpayer with whom CDE files
4
If applicable, EIN of parent taxpayer with whom CDE files
a consolidated tax return
a consolidated tax return
5
Name of taxpayer making qualified equity investment
6
TIN of taxpayer making qualified equity investment
7
Date of qualified equity investment (mm/dd/yyyy)
8
Amount of qualified equity investment
9
Total allowable credit
10a Allowable credit: Year 1
b Allowable credit: Year 2
c Allowable credit: Year 3
d Allowable credit: Year 4
e Allowable credit: Year 5
f Allowable credit: Year 6
g Allowable credit: Year 7
Under penalties of perjury, I declare that the qualified equity investment identified above was received by the CDE identified above.
Please
Sign
Signature of authorized official of CDE
Date
Here
Type or print name
8874-A
For Paperwork Reduction Act Notice, see instructions.
Form
(Rev. 12-2011)
Cat. No. 49311G

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