Form Pte - Virginia Pass-Through Credit Allocation - 2003
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1VA0PTE103777
Form PTE - Virginia Pass-Through Credit Allocation
• Use this form to allocate a tax credit to the taxpayers listed in Section II.
• The information in Section II may be submitted as an attachment provided
Mail Form to:
that the attachment lists only the required information.
Virginia Department of Taxation
• Any pass-through listed in Section II must complete a separate Form PTE.
Tax Credit Administration Unit
• Allocations must be shown in whole dollars and the total allocations
PO Box 715
listed in Section II must equal the amount shown in Section I, d.
Richmond, VA 23218-0715
• Form PTE should be filed as soon as possible, but at least 30 days prior to
Or Fax to: 804-786-2800
the participants (listed in Section II) filing their Income Tax Returns to avoid
For Assistance, Call 804-786-2992
delays at the time of annual return processing.
• Please ensure that the information provided on this form is accurate. Documentation will be required for any changes.
Section I - Credit Information
a.) Pass-Through Entity FEIN
a.) Pass-Through (Entity Filing Form) Name
c.) Tax Year
d.) Amount Granted/Allocated
e.) Certificate Number, If Applicable
f.) Credit Type - Check One
(ER) Enterprise Zone Credit for Real Property Businesses
(LI) Low Income Housing Credit
(EE) Enterprise Zone Credit for Existing Businesses
(NA) Neighborhood Assistance Credit
(EN) Enterprise Zone Credit for New Businesses
(RB) Riparian Buffer Credit
(EI) Enterprise Zone Credit for Zone Investment
(ED) Qualified Business Credit
(RR) Rent Reduction Credit
(WR) Worker Retraining Credit
(HR) Historic Rehabilitation Credit
(DF) Day-Care Facility Investment Credit
Section II - Credit Allocation
Taxpayer Information
Amount
1 SSN/FEIN
Name
Street Address or PO Box
City, State, ZIP
2 SSN/FEIN
Name
Street Address or PO Box
City, State, ZIP
3 SSN/FEIN
Name
Street Address or PO Box
City, State, ZIP
4 SSN/FEIN
Name
Street Address or PO Box
City, State, ZIP
5 SSN/FEIN
Name
Street Address or PO Box
City, State, ZIP
6 SSN/FEIN
Name
Street Address or PO Box
City, State, ZIP
7 SSN/FEIN
Name
Street Address or PO Box
City, State, ZIP
Total
Must equal the amount shown in Section I, d.
Section III - Authorized Signature
Authorized Signature
Title
Print Name
Telephone Number
Fax Number
Virginia Department of Taxation 2601430 (Rev 7/2003)
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