Schedule Rz - Schedule For Renaissance Zone Income Exemption And Tax Credits

North Dakota Office of State Tax Commissioner

2012 Schedule RZ, page 3

Taxpayer's name as shown on tax return

Social security number (or FEIN, if applicable)

Part 4 Historic property preservation or renovation tax credit

See the instructions for Part 4 on page 8 of the booklet.

Project number assigned by the local zone authority (Attach a copy of final zone project approval letter)

Renaissance zone city in which the project is located

Street address of project property

Does taxpayer have more than one zone project at the address shown on line 3 above?

Yes

If yes, enter all of the project numbers here

Total amount paid to preserve or renovate the qualifying historic property . . . . . . . . . . . . . . . . . . . . .

a. Multiply line 5 by 25% (.25) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

250,000

b. Maximum tax credit per project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c. Enter the lesser of line 6a or line 6b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6c

Historic tax credit from a passthrough entity (Attach copy of North Dakota Schedule K-1) . . . . . . . . . . .

Carryforward from 2011 tax year (from 2011 Schedule RZ, Part 4, line 11) . . . . . . . . . . . . . . . . . . . . .

Total available credit (Add lines 6c, 7 and 8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10.

Credit for 2012 tax year (See instructions) (Attach statement) Enter here and on page 4, Part 7,

line 4, of this schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Carryforward to 2013 tax year (See instructions) (Attach statement) . . . . . . . 11

11.

Part 5 Renaissance fund organization (RFO) investment tax credit

See the instructions for Part 5 on page 9 of the booklet.

Renaissance zone city having the RFO in which investment was made

Amount invested in the RFO during the 2012 tax year (Attach a copy of the Renaissance Fund

Organization Investment Reporting Form received from the RFO) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Multiply line 2 by 50% (.50) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

RFO tax credit from a passthrough entity (Attach copy of North Dakota Schedule K-1) . . . . . . . . . . . . . .

Carryforward from 2011 tax year (from 2011 Schedule RZ, Part 5, line 8) . . . . . . . . . . . . . . . . . . . . . .

Total available credit (Add lines 3, 4, and 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Credit for 2012 tax year (See instructions) (Attach statement) Enter here and on page 4, Part 7,

line 5, of this schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Carryforward to 2013 tax year (See instructions) (Attach statement) . . . . . . .

Attach all 4 pages of Schedule RZ to the North Dakota return

Schedule Rz - Schedule For Renaissance Zone Income Exemption And Tax Credits - 2012 Page 3