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eligible

THISTAX PERIOD, forwhich

-8-

NAME AND ADDRESS

RENT/LEASE

Enter the name of the new or expanded facility. The address must

(Item 7) - If this new or expanded facility is being leased or rented,

be the Missouri location where the development occurred. P.O. BOXES

enter the the net MONTHLY rental/lease rate on Line (7). The term

OR DRAWER NUMBERS ALONE WILL NOT BE ACCEPTED. DO NOT

“ net monthly rental/lease rate,” means the monthly rental/lease rate

COMBINE FACILITIES. EACH FACILITY MUST BE FILED

paid by the taxpayer for REAL and TANGIBLE PERSONAL property

SEPARATELY.

IN USE at this facility (land, building, machinery, equipment, furniture,

fixtures and other depreciable tangible personal property, BUT NOT

CREDITS CEASE IF A FACILITY MOVES FROM THE INITIAL

INVENTORIES) less any monthly rental/lease rates received by the

QUALIFYING ADDRESS LISTED ON FORM 135.

taxpayer from subrentals or subleases.

IDENTIFICATION NUMBERS

MULTIPLE BUSINESSES

Enter the FACILITY’ S Federal Employer Identification (FEIN) number,

(Item 6) - If the taxpayer claiming these tax benefits has interest in

the TAXPAYER’ S FEIN number ONLY IF DIFFERENT, and the

any other business in Missouri (besides the business that has

FACILITY’ S Missouri Tax Identification Number.

established this new or expanded facility) for which a SINGLE

NOTE: IF THE RETURN IS FILED UNDER ANOTHER FEIN NUMBER

MISSOURI TAX RETURN IS FILED, check Item (8) “ yes.”

AND NAME, ATTACH THE OTHER NAME(S).

(Item 6a) - Enter the NAMES and FEIN NUMBERS of these other

ENTERPRISE ZONE LOCATION

businesses in Item (8a).

(Item 1) - If the facility’ s address above is within one of Missouri’ s

MULTIPLE FACILITIES

designated enterprise zones, check item (1) “ yes.” If the facility IS

(Item 9) - If the taxpayer claiming these tax benefits operated any

in an enterprise zone, answer all questions on this form. If the facility

in Missouri (besidesthisfacility) AT ANY TIME DURING

facilities

other

IS NOT in an enterprise zone, answer all questions on this form

SINGLE MISSOURI RETURN IS FILED,

EXCEPT Items (10) through (12).

check Item (9) “ yes.”

MAILING ADDRESS

(Item 2) - If the taxpayer wants the Certificate of Eligibility, as well

ITEMS 10 THROUGH 12 ARE TO BE COMPLETED ONLY BY

as any correspondence regarding these benefits to be mailed to a

TAXPAYERS CLAIMING ENTERPRISE ZONE TAX BENEFITS. DO

person and/or address OTHER than the facility’ s address provided

NOT COMPLETE lo-12 IF THIS FACILITY IS NOT WITHIN A ZONE.

above, enter the OTHER name and address in this space.

TRAINING

PERSON COMPLETING APPLICATION

(Item 3) - Enter the name, address and telephone number of the person

(Item 10) - If the taxpayer incurred costs to train employees AT THIS

who completed this application and WHO CAN ANSWER DETAILED

ENTERPRISE ZONE FACILITY DURING THIS TAX PERIOD, and if

QUESTIONS ABOUT THIS APPLICATION. This person will receive

the trainees were either residents of the enterprise zone or “ difficult

copies of all correspondence, including the Certification of Eligibility.

to employ” (unemployed at least 3 months prior to being hired at

this facility), check Item (10) “ yes” AND COMPLETE SCHEDULE B.

BUSINESS ENTITY

(Item 4) - Check the box which describes this business entity FOR

NOTE: Training credits may be earned even if government funds have

TAX PURPOSES. If the taxpayer is a fiduciary, individual proprietor-

been used in the training program, but only if the EMPLOYER’ S

ship, partnership or corporation organized under Subchapter S of the

ACTUAL COSTS were over $400 per employee. The credit per

Internal Revenue Code, tax benefits will be apportioned among the

employee is equal to 80% OF COSTS OVER $400, UP TO A MAXIMUM

beneficiaries, owners, partners or shareholders in the same proportion

OF $400 PER EMPLOYEE. (See Schedule B instructions.)

as their share of ownership ON THE LAST DAY OF THE TAX PERIOD.

RESIDENTS

LIST THE NAMES, SOCIAL SECURITY NUMBERS AND PROPOR-

(Item ll)- If thetaxpayerclaiming thesetax benefitsemployed persons

TIONED SHARE OF OWNERSHIP OF EACH BENEFICIARY,

at this enterprise zone facility DURING THIS TAX PERIOD, and IF

PARTNER OR SHAREHOLDER ON THE LAST DAY OF THE TAX

THESE EMPLOYEES LIVED WITHIN THIS ENTERPRISE ZONE

PERIOD.

DURING THIS TAX PERIOD, check Item (11) “ yes” AND COMPLETE

SCHEDULE C. All addresses must be verified by the enterprise zone

BUSINESS ACTIVITY

representative (see instructions, pages 13-14).

(Item 5) - Describe the commercial operations being conducted at

this new or expanded facility. BE SPECIFIC, e.g. manufacturer of

NOTE: Resident employees may have been hired at any time (they

women’ s apparel. If you know the Standard Industrial Classification

may be long-term employees).

(SIC) for this facility, enter the 4-digit number in (5a).

SPECIAL EMPLOYEES

NOTE: If the taxpayer conducts multiple business activities at this

(Item 12) - If the taxpayer claiming these tax benefits hired persons

facility; and if some of these activities are NOT ELIGIBLE for these

at this enterprise zone facility, who at the time they were hired, met

facilities

credits (see lists of

page 2), EACH ACTIVITY MUST

the criteria listed below, AND WHO WERE STILL EMPLOYED AT THIS

FACILITY DURING THIS TAX PERIOD, check Item (12) “ yes” AND

BE APPORTIONED. On a separate sheet of paper attached to this

application, indicate the total square feet at this facility and the total

COMPLETE SCHEDULE D.

square feet utilized by each activity; and/or the total number of

Special Employee Criteria: the employee must be either 1) “ difficult

persons employed at the facility and the total number employed

to employ” - unemployed at least 3 months prior to being hired for

in each activity; and/or the total sales or investment attributed to

this new or expanded portion of this facility; OR 2) ELIGIBLE for Aid

or employed in the facility and the proportionate share of each

to Families with Dependent Children (AFDC) OR the General Relief

activity; and/or any other indicator which the taxpayer believes

Program.

accurately represents or describes the proportioned share of each

business activity.

NOTE: Special employees MUST HAVE BEEN HIRED NO EARLIER

THAN THREE MONTHS PRIOR TO THE COMMENCEMENT DATE

PRIOR TAX CREDITS

entered on Line (13) of Form 135: THE EMPLOYEE MUST HAVE BEEN

(Item 6) - Enter the FIRST tax period when these tax benefits were

HIRED FOR THIS SPECIFIC DEVELOPMENT.

INITIALLY CERTIFIED OR EARNED on Line (6a); the amount of credits

actually CERTIFIED by this Department, and the amount of credits

SIGNATURE

that were actually CLAIMED on the taxpayer’ s return for that tax period.

An unsigned application, form or schedule is invalid. The taxpayer

Enter the same information for each subsequent tax period the tax

claiming these tax benefits OR HIS DESIGNEE, AND THE TAX

credits were earned and claimed. IF THE AMOUNTS ARE UNKNOWN,

PREPARER, must sign and date all applicable documents, subject to

ENTER THE TAX PERIOD(S) ONLY.

the penalties of perjury.

MO 419-1524 (12-95)

Form 135 Instructions - New/expanded Business Facility And Enterprise Zone: I Application For Initially Claiming Tax Benefits Page 3

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