Form Machinery And Equipment Investment Tax Credit Worksheet - State Of Maine - 2004
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12004
Machinery and Equipment Investment
Tax Credit Worksheet
36 MRSA, §5219-E
1. Business name: ________________________________________________________________________
Address: ______________________________________________________________________________
2. Business code: _______ Federal EIN: ____ - ______________ Tax year ending: ___________
3. Business type:
Corporation
S Corporation
Partnership
Sole Proprietorship
4. Schedule of machinery and equipment (see instructions)
List
Original
Date Placed
Physical Location
Machinery and Equipment
Basis
in Service
(City/State)
a.
$
b.
c.
d.
e.
f.
g.
h.
Total basis: $
5. Was the listed machinery and equipment subject to depreciation on the federal return for the taxable year?
Yes
No
6. Was the machinery and equipment used directly and primarily in the production of tangible personal property
intended to be sold or leased ultimately for final consumption?
Yes
No
(Describe the usage below.)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
7. Was the equipment purchased “used” within Maine?
Yes
No
If yes, indicate seller: ______________________________________________________________________
8. Schedule of shareholders or partners and allocation of the basis (see instructions)
List
Social Security
Shareholders/Partners
Number
Share %
Basis Allocated
a.
b.
c.
d.
e.
f.
g.
h.
9. Multiply each taxpayer’s Basis Allocated by 1% (.01) and write the result on the taxpayer’s Maine Schedule A, line
18. File a copy of this worksheet with the taxpayer’s Maine return.
(
)
10. Contact person (type or print): __________________________ Telephone: __________________________
Rev. 12/04
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