Form Int-2 - Report Of Investment In Project For Income Tax Capital Credit
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FORM
A
D
R
LABAMA
EPARTMENT OF
EVENUE
INT-2
Report of Investment in Project
DEPARTMENT USE ONLY
CONTROL NUMBER
for Income Tax Capital Credit
___________________
03/14
This form is used to report the actual costs of a capital project and date the project was placed in service.
The project number originally assigned by the Alabama Department of Revenue must be indicated.
Project Number:
Project Name:
Project Entity:
FEIN:
Address:
Telephone No.: (
)
City:
State:
ZIP:
NAICS:
Project Location (if different from above):
Project filing status: (
only one)
S Corporation
Partnership
LLC
C Corporation
Estate/Trust
Sole Proprietorship
1a. Type of project:
Industrial, Warehousing, or Research Activity
Small Business Addition
Headquarters Facility
Data Processing Center
Research and Development Facility
Renewable Energy Facility
State Docks
Tourism Destination Attraction
Hydropower Electricity Production
Warehousing or Storage
Alternative Energy Resources Electricity Production
1b. Is project located in a Favored Geographic Area?
Yes
No
2.
Type of trade or business conducted at the project:
3.
Description of project (Attach additional sheets if necessary. If project was phased, describe each phase.):
4.
Date project was placed in service (If project was phased, enter actual date last phase placed in service.):
7.
Number of new employees employed by
5.
Actual Project Costs:
this project: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
a. Building. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8.
Average hourly wage for new employees
b. Land . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
employed by this project:. . . . . . . . . . . . . . . . . . . . . .
c. Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d. Architectural and Engineering . . . . . . . . . . . . . . . . . . .
e. Landscaping. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
f. Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$ 0
6a. Total Actual Project Costs . . . . . . . . . . . . . . . . . . . . . . . . .
$ 0
6b. Annual Credit Available (multiply line 6a by 5%) . . . . . . .
9.
Has investing company reduced its workforce in Alabama within two years of project being placed in service?
Yes
No
10. Has an investing company in the project closed a facility in Alabama within two years of project being placed in service?
Yes
No
If yes, complete the following:
Date of closure:
Number of employees at the date of closure:
Location of facility:
11.
Has any of the property identified in line 5 been previously placed in service in Alabama by an investing company or a related party?
Yes
No
12.
Contact person for capital credit and to whom all correspondence will be sent:
Allocations of Capital Credit
A complete list of all participants in the project entity entitled to receive the Capital Credit must be provided. (Attach additional sheets if necessary.)
1.
Name:
2.
Name:
Address:
Address:
City:
State:
Zip:
City:
State:
Zip:
Social Security No. or FEIN:
Social Security No. or FEIN:
Percentage Allocation of Credit:
%
Percentage Allocation of Credit:
%
Under penalties of perjury, I declare that I am duly authorized to complete this form and that I have listed all the participants of the project entity. I have examined
the above statements and to the best of my knowledge and belief they are true, correct, and complete.
Your Signature:
Title:
Date:
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