Seed Capital Investment Tax Credit Worksheet For Tax Year 2012

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SEED CAPITAL INVESTMENT TAX CREDIT
WORKSHEET FOR TAX YEAR 2012
36 M.R.S.A. § 5216-B
Note: If you are a private venture capital fund claiming this credit, call Maine Revenue Services at 207-624-9547 for
special instructions.
TAXPAYER NAME: _____________________________________ EIN/SSN: ________________
Note:
Owners of pass-through entities (partnerships, LLCs, S corporations, trusts, etc.) making an eligible investment, see instructions. Enter
name and ID number of the entity on the lines below. Also enter your ownership percentage in the pass-through entity for the tax year.
OWNERSHIP
NAME OF PASS-THROUGH ENTITY
EIN/SSN
PERCENTAGE
_______________________________________________
_______________________
________ %
1. Investment credit certifi cate amounts for investments made January 1, 2009 through
December 31, 2009. ______________________ X .25 (attach copy of certifi cate) ............................ 1. ______________________
2. Investment credit certifi cate amounts for investments made January 1, 2010 through
December 31, 2010. ______________________ X .25 (attach copy of certifi cate) .............................2. ______________________
3. Investment credit certifi cate amounts for investments made January 1, 2011 through
December 31, 2011. ______________________ X .25 (attach copy of certifi cate) .............................3. ______________________
4. Investment credit certifi cate amounts for investments made January 1, 2012 through
December 31, 2012. ______________________ X .25 (attach copy of certifi cate) .............................4. ______________________
5. Current year credit (add lines 1 through 4) ...........................................................................................5. ______________________
6. Unused credit amounts carried to 2012. Enter amount from 2011 Seed Capital Investment
Tax Credit worksheet, line 10 ...............................................................................................................6. ______________________
7. Total credit available this year (add lines 5 and 6) ............................................................................... 7. ______________________
8. Tax before credits (Form 1120ME, line 7a or Form 1040ME, line 23 minus
line 25) ________________________________ X .50 ...................................................................... 8. ______________________
9. Credit amount: Enter the smaller of line 7 or line 8 (enter here and on
Form 1120ME, Schedule C, line 29a or Form 1040ME, Schedule A, line 8) ....................................... 9. ______________________
10. Carryover to next year (see instructions) ........................................................................................... 10. ______________________
11. Amount of credit available for future years relating to credit certifi cates issued for eligible
investments made in 2012.
a. 2013 (line 4 above) ....................................................................................................................11a. ______________________
b. 2014 (line 4 above) ....................................................................................................................11b. ______________________
c. 2015 (line 4 above) .................................................................................................................... 11c. ______________________
12. Recapture
a. The amount of the original credit certifi cate revoked by FAME .................................................. 12a. ______________________
b. The amount of the original credit certifi cate not yet claimed as a credit .....................................12b. ______________________
c. Recapture amount. Subtract line 12b from line 12a. Enter amount here. If the amount is
positive, this is the recapture amount. Enter on Form 1120ME, line 7b or Form 1040ME,
Schedule A, line 1. If the amount is negative, this is the amount of credit still available ............12c. ______________________
Unused credit amounts may be carried forward for up to 15 years.
Rev. 8/12

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