Employer-Assisted Day Care Tax Credit Worksheet For Tax Year 2011

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EMPLOYER-ASSISTED DAY CARE TAX CREDIT
WORKSHEET FOR TAX YEAR 2011
36 MRSA § 5217
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.
NAME OF PASS-THROUGH ENTITY
EIN/SSN
________________________________________________________________
____________________________
1. Number of employees’ children enrolled full-time (or number of full-time equivalents)
in day care services provided/paid for by the employer in
2011 (see instructions) .....................................................................................................1. _____________________
2. Line 1 x $100 ...................................................................................................................2. _____________________
3. Actual costs incurred in providing day care services for children of
employees for the taxable year ........................................................................................3. _____________________
4. Line 3 x 20% (0.20) ..........................................................................................................4. _____________________
5. Enter the lowest of line 2, line 4 or $5,000 .......................................................................5. _____________________
6. Do any of the day care services provided in 2011 qualify as quality child care
services? (see instructions) ................................................................................................
Yes
No
If yes, enter the certifi cate number(s) ________________________
of the quality child care certifi cate(s) issued to the facility by the Department of
Health and Human Services, Offi ce of Child Care and Head Start.
Enter credit amount from line 5 that relates to amounts paid for quality child care
services ............................................................................................................................6. _____________________
7. Line 6 x 2 .........................................................................................................................7. _____________________
8. Line 5 minus line 6 (not less than zero) ...........................................................................8. _____________________
9. Current year credit claimed (line 7 plus line 8) .................................................................9. _____________________
10. Credit carried forward/back from other tax years (see instructions) ..............................10. _____________________
11. Total credit available this year (line 9 plus line 10). Corporate taxpayers, enter this
amount on Form 1120ME, Schedule C, line 29c. Individuals, enter this amount on
Form 1040ME, Schedule A, line 18 ............................................................................... 11. _____________________
If this is the only Maine income tax credit you are claiming this year, complete lines 12 and 13. Otherwise, go to line 14.
12. Tax Liability. Enter the amount from Form 1120ME, line 7a or Form 1040ME,
Schedule A, line 20 ........................................................................................................12. _____________________
13. Credit Used. Enter the lesser of line 11 or line 12 .........................................................13. _____________________
14. Carryback/carryforward amount available for other tax years:
a.
If you completed lines 12 and 13, subtract line 13 from line 11.
b.
If you did not complete lines 12 and 13, enter the amount from line 11 not
used on Form 1040ME, Schedule A or Form 1120ME, Schedule C as a result
of claiming other Maine credits and because the total of all credits claimed is
limited to the Maine tax liability ............................................................................14. _____________________
Rev. 2/12

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