Section 2 - Alternative Simplified Credit Calculation
Column A
Column B
All Qualified Research and
College and University
See instructions and Schedule C for information on calculating the Adjusted
Development Amounts
Related Research and
Calendar Year Qualified Research and Development Expenses.
Development Amounts
1.
Total Adjusted Calendar Year Qualified Research and Development
Expenses. Enter the amount(s) from Schedule C, Line 4e in the applicable
column(s). Taxpayers without qualified research and development
expenses for the preceding 3 taxable years, enter the applicable
amount(s) from Schedule C, Line 1a in the applicable column(s).
.00
.00
$
$
2.
Credit Computation.
If you incurred research and development expenses for the
3 preceding taxable years, check here and multiply the amount on
Line 1, Column A and Line 1, Column B (if applicable) by 10% (0.1).
If you did not incur research and development expenses for the
3 preceding taxable years, check here and multiply the amount on
Line 1, Column A and Line 1, Column B (if applicable) by 5% (0.05).
.00
.00
$
$
3.
Credit Requested. Enter the greater of Line 2, Column A (not to exceed $45,000) or Column B (not to
exceed $60,000).
.00
$
Section 3 - Credit Information
1.
Number of full time employees during the year for which the credit is sought.
2.
Total gross receipts or anticipated gross receipts for the taxable year the credit is sought.
If research was conducted in conjunction with a Virginia public or private college or
3.
university, enter name of college or university. Attach a copy of the agreement.
4.
If you applied for any other credits this year, identify the credit(s) below.
5.
Research Field:
Biotechnology
Cyber Security
Engineering
Food & Beverage Development
Industrial
Medical
Technology
Other ______________________
6.
Provide a brief description of the area, discipline, or field of Virginia qualified research performed. Attach statement or other
documentation if more space is needed.
Do you conduct research and development in Virginia on human cells or tissue derived from
7.
induced abortions or from stem cells obtained from human embryos?
Yes
No
8.
If you are a pass-through entity, do you plan to allocate your credit?
Yes
No
I (we) the undersigned declare, under the penalties provided by law, that this form (including any accompanying schedules, statements,
and attachments) has been examined by me (us) and is, to the best of my (our) knowledge and belief, a true, correct, and complete
application, made in good faith pursuant to the income tax laws of the Commonwealth of Virginia.
Authorized Signature
Title
Date
Printed Name
Phone Number
Email Address
Fax Number
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