Form Wv/cfs-1 - Convenience Food Store Tax Credit Schedule
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1Form WV/CFS-1
CONVENIENCE FOOD STORE
Orig. 11/98
TAX CREDIT SCHEDULE
(W.Va. Code § 21-13-5)
Tax Period From:
To:
Business Name
West Virginia Identification Number
Business Address (Please include City, State and Zip Code)
Part 1 - Store Information - If more space is needed, attach additional sheets
C o l u m n I
Column II
Column III
Column IV
N a m e a n d a d d r e s s
Gross receipts per
D a t e s e c u r i t y c a m e r a
A c t u a l c o s t o f
o f e a c h c o n v e n i e n c e f o o d
s t o r e f o r w h i c h
w a s i n s t a l l e d a t t h e
installing security
s t o r e f o r w h i c h t h e
the credit is claimed
store
c a m e r a a t e a c h
credit is claimed
M M / D D / YY
store, or $500,
whichever is less
a .
b .
c .
d .
2. Total maximum credit available from all qualifying convenience stores.
(Add the amounts in Column IV, Lines 1a. through 1d.) .......................................................
3. Total gross income earned from all qualifying convenience stores. .......................................
4. Total gross income from all sources. ..................................................................................
5. Percentage of gross income earned from all qualifying convenience stores.
(Line 3 divided by Line 4. State as a decimal, not more than 1.0.) .......................................
6. Income tax liability before tax credits. .................................................................................
7. Income tax liability attributable to all qualifying convenience stores.
(Multiply Line 5 by line 6.) ..................................................................................................
8. Total convenience food store credit. (Line 2 or Line 7, whichever is less.) .............................
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Parent category: Financial