State Form 21928 - Schedule It-40qec - Enterprise Zone Qualified Employee Deduction Certificate - 2010

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Schedule IT-40QEC
Indiana Department of Revenue
Enclosure
2010
State Form 21928
Enterprise Zone
Sequence No. 18
(R5 / 9-10)
Qualified Employee Deduction
Certificate
--- File with your Indiana individual income tax return ---
Name of employee
Social Security Number Name of Enterprise Zone ___________
Date of residence in Enterprise Zone:
From ____________ To ____________
Employee’s street address
Amount of compensation for tax year
during the period of residence in the
Enterprise Zone: $_________________
City of residence
Caution: Limitation of Deduction
Enter ½ of the above amount or $7,500,
whichever is less: $________________
Employer
Address
Federal Identification Number
I certify that the above-named employee was paid the amount indicated as compensation for services rendered, and that he/she is a
qualified employee as defined in I.C. 6-3-2-8.
Signature of employer
Title
Telephone number
Date
Instructions for completing Schedule IT-40QEC
Schedule IT-40QEC is to be completed by the enterprise zone employer and distributed to its qualified employee(s). The qualified em-
ployee should claim this deduction on IT-40 Schedule 2, IT-40PNR Schedule C, or Form IT-40X (amended tax return). The employee
must enclose the IT-40QEC with the state individual income tax return to support any claimed deduction of earned enterprise zone
income.
Indiana Code I.C. 6-3-2-8 defines a “qualified employee” as an individual who:
1.
Has a principal place of residency in the enterprise zone where employed;
2.
Performs services for the employer 90 percent of which are directly related to the conduct of the employer’s trade or business
located in an enterprise zone;
3.
Performs services for the employer at least 50 percent of the time during the taxable year within an Indiana state enterprise
zone; and
4.
Is employed by a business that remains eligible to receive benefits and incentives as provided by enterprise zone legislation.
Portions of certain Indiana cities are designated as state enterprise zones. Also, certain airport development zones may substitute as
enterprise zones. A qualified employee living and working in a designated enterprise zone may be entitled to deduct from state
adjusted gross income one-half of the enterprise zone income earned for services or $7,500, whichever is less. Enterprise zone
income means wages, salaries, commissions and any other forms of remuneration paid to qualified employees for services by an enter-
prise zone employer, minus any IRA deductions directly related to that earned income.
For a listing of all current enterprise zones and contact information for each zone please visit
Privacy Notice: The records in this series are CONFIDENTIAL according to the provisions of I.C. 6-8.1-7-1 and I.C. 5-28-15-8
*21310111694*
21310111694

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