Arizona Form 304 - Enterprise Zone Credit - 2002 (Page 5 of 6) in pdf

Arizona Form 304 - Enterprise Zone Credit - 2002 Page 5

Employees at Enterprise Zone Location

Form 304-1 (2002)

Complete a Form 304-1 for each employee at the enterprise zone location. Provide the following information for each employee (whether or not

the employee is in a qualiﬁ ed employment position).

1 Employee name

2 Employee’s taxpayer identiﬁ cation number (TIN)

3 Employee’s residence address

4a Is the residence address listed on line 3 inside or outside of an enterprise zone that is located in the same county in which

the business is located?

Yes

4b If the answer on line 4a is yes, list the name of the enterprise zone in which the employee’s residence address is located

5 Employee’s residence address AT DATE OF HIRE

6a Is the residence address listed on line 5 inside or outside of an enterprise zone that is located in the same county in which

the business is located?

Yes

6b If the answer on line 6a is yes, list the name of the enterprise zone in which the employee’s residence address was located

7 Date of initial employment __________________________________

8 If employee was previously employed by the business, list the last date of employment. (See instructions)

_______________________________________

9a Is the employee in a permanent full time position? (See instructions)

Yes

9b If the answer to line 9a is yes, list the number of hours the employee worked during the taxable year

10 Employee’s annual compensation for the taxable year $

11a Total cost of health insurance provided by employer for employee. (See instructions) $

11b Total cost of health insurance for employee paid by employer. (See instructions) $

12 Is this employee in a new qualiﬁ ed employment position?

Yes

13a Has this employee been substituted for another employee in a qualiﬁ ed employment position?

Yes

13b If answer to line 13a is yes, list the year of substitution. (See instructions)

Check only one box.

second year employee

third year employee

ADOR 91-0050 (02)

Arizona Form 304 - Enterprise Zone Credit - 2002 Page 5