Form Ccp-100 - Coal Combustion Credit Application Page 2
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3CCP-100
Step 3: For taxpayers qualifying for the credit under Section B(3), the credit is equal to the difference between the number of tons
of coal combustion products obtained and used by the manufacturer in the taxable year and the amount entered in step
2 of Section D line 1, multiplied by $2.
1. Tons obtained & used
2. Subtract step 2
3. Subtotal
4. Multiplied by
x
$2
5. Available credit
E. Use of credit(s)
Indicate how you anticipate using this credit:
Corporate Income Tax
Partnership Return
Individual Income Tax (Sole Proprietor)
Note: If the credit is being claimed by a shareholder, partner, or member of a pass-through entity, you must attach a list providing the
name, SSN/FID, and percentage of the pass-through entity’s distributive income to which the shareholder, partner, or member is entitled.
F. Signature
Under penalties of perjury, I declare I have examined this return, including all accompanying attachments, and to the best of
my knowledge and belief it is true, correct, and complete.
Printed Name and Title
Telephone Number
Signature
Date
Application can be faxed to (317) 615-2697
or mailed to:
Indiana Department of Revenue
Tax Administration
P.O. Box 6197
Indianapolis, IN 46204
If you have questions, please call (317) 232-2339.
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