Form N-330 - School Repair And Maintenance Tax Credit
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STATE OF HAWAII—DEPARTMENT OF TAXATION
SCHOOL REPAIR AND MAINTENANCE
FORM
TAX
N-330
YEAR
TAX CREDIT
20_ _
(REV. 2004)
Or fiscal year beginning _________________, 20____, and ending __________________, 20____
ATTACH TO FORM N-11, N-12, N-15, N-20, N-30, N-35, N-40, OR N-70NP, WHICHEVER IS APPLICABLE.
Name(s) as shown on Form N-11, N-12, N-15, N-20, N-30, N-35, N-40, or N-70NP
SSN or FEIN
DEPARTMENT OF EDUCATION CERTIFICATE
(Completed by the Department of Education only)
1. Name
2. SSN/FEIN
3. Address (Number and street, including apartment number or rural route, city, state, and zip code)
4. Value of the contributed in-kind services
5. Date contribution made
$
6. Contractor is licensed under:
7. Contractor’s or RME’s License No.
8. Dept. of Taxation Tax Clearance
£
Chapter 444, HRS
Certificate obtained (see instructions)
£
£
Chapter 460J, HRS
Yes
£
£
Chapter 464, HRS
No
(See instructions)
This is to certify that the contractor above has contributed in-kind services in accordance with Act 213, Session Laws of Hawaii 2004.
Signature of Certifying Officer
Date of Certification
(Type or Print Name and Title)
COMPUTATION OF TAX CREDIT (Completed by Taxpayer)
Note: If you are claiming the Ethanol Facility Tax Credit, no other credit can be claimed for the taxable year. Skip lines 9
through 11 and begin on line 12.
Note: If you are only claiming your distributive share of a tax credit distributed from a partnership, an S corporation, an
estate, or a trust, skip lines 9 through 10 and begin on line 11.
9
Enter the certified value from line 4 or $40,000, whichever is less (see instructions) ................................
9
10 Multiply line 9 by 10% (.10) and enter result here......................................................................................
10
11 Flow through of Hawaii school repair and maintenance tax credit received from other
entities, if any: Check box below.
Enter Name and Federal Employer I.D. No. of Entity:
__________________________________________________________________________________
£
a Partner — enter amount from Schedule K-1 (Form N-20), line 24 .................................................
£
b S corporation shareholder — enter total from Schedule K-1 (Form N-35), line 12m......................
£
c Beneficiary — enter amount from Schedule K-1 (Form N-40), line 10 ...........................................
£
d Patron — enter the amount from federal Form 1099-PATR...........................................................
11
12 Carryover of unused school repair and maintenance tax credit from prior year.........................................
12
13 Add lines 10 through 12 and enter the total or $4,000, whichever is less, here. This represents your
tentative current year school repair and maintenance tax credit. Form N-20, N-35, and N-40 filers, stop
here and see the instructions before proceeding to line 14........................................................................
13
(Continued on back)
FORM N-330
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