Fillable Form Tc-40v - Clean Fuel Vehicle Tax Credit printable pdf download

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Utah State Tax Commission

TC-40V

Clean Fuel Vehicle Tax Credit

Get forms online - tax.utah.gov

Rev. 7/06

Do not send this form with the return. Keep this form and all related documents with your records. You must

complete a new form each year you claim a carryforward credit.

Taxpayers may claim a nonrefundable credit on their individual income tax, corporate franchise tax or fiduciary tax

returns for the purchase or conversion of vehicles that use cleaner burning fuels. A separate form must be completed

for each vehicle claimed. The credit may only be taken once per vehicle. It must be certified and claimed in the taxable

year in which the item is purchased or converted. If the credit claimed exceeds the tax liability for a taxable year, the

credit that exceeds the liability may be carried forward for up to five taxable years. See instructions on reverse side.

NOTE: A hybrid vehicle does not qualify for the clean fuel vehicle credit for tax years beginning after 2005.

Part A - This section must be completed by the taxpayer

Taxpayer's name

Telephone number

Social security number or EIN

Address

City

State and ZIP code

Vehicle Identification Number

Part B - This section must be completed by the Division of Air Quality, Department of Environmental Quality

Indicate the following:

Propane

Natural gas

Electricity

Other___________; or

The vehicle is fueled by

(check all that apply):

Gasoline

Diesel

The vehicle meets clean fuel vehicle standards in the federal Clean Air Act

(a vehicle manufactured

Converted vehicle

OEM Vehicle

Converted special mobile equipment

to use a clean fuel)

Certification by the Division of Air Quality, Department of Environmental Quality

I certify to the best of my knowledge and belief the information contained in Parts A and B above are true and complete.

Date signed

DEQ original stamp of approval (required)

Authorized signature (required)

Title

Part C - This section must be completed by the taxpayer

Amount of qualifying expenditures

Amount of credit claimed (See General Instructions on reverse side

for credit limitations)

IMPORTANT - PLEASE READ

Refer to the instructions for your INCOME TAX (TC-40), CORPORATE TAX (TC-20 or TC-20S),

or FIDUCIARY TAX (TC-41) return to determine the line number on which you will record this credit.

The credit code is "05" for all returns.

The Air Quality

certification signature

may be obtained by mailing or presenting this form with the required

documentation to Division of Air Quality, 150 North 1950 West, SLC, UT 84116, telephone (801) 536-4026.

For further information regarding the

tax credit

, contact the Utah State Tax Commission at (801) 297-2200 or

1-800-662-4335, outside the Salt Lake area.

Americans with Disabilities Act accommodations: For

tax information

, contact the Tax Commission at (801) 297-3811

(TDD 297-2020). Please allow three working days for a response.

Form Tc-40v - Clean Fuel Vehicle Tax Credit

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