Form Fpc - Film Production Credit - 2011 Page 3

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Form FPC, Page 3 - 2011
SSN
OR FEIN
Schedule II, Qualified Expenditures Credit
► If you have more than 20 qualified expenditures, you may use a document formatted similar to Schedule II as a
substitute for Schedule II.
► Do not include the expenditures listed below as a deduction when computing your net income for corporation license
tax or individual income tax purposes.
Column A
Column B
Column C
Column D
Enter the name of the business
Enter a brief description of the qualified
Enter the date
Enter the total
or individual to which a qualified
expenditure (i.e. lumber, lodging, meals,
of the qualified
amount of
expenditure was made.
maintenance, etc).
expenditure
the qualified
expenditure.
1. Enter in line 1, column D, the aggregate amount of expenditures previously reported at the
completion of principal photography. Include a copy of your previously submitted Form FPC-PP
with this application. ....................................................................................................................... 1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22. Add the amounts in Column D and enter the result here. ............................................................ 22.
23. Multiply the amount in Column D, line 22 by 0.09 (9%) and enter the result here and
on page 1, line 2. This is your qualified expenditures credit. .................................................. 23.
Certification Statement
I, ____________________________________________ , certify under penalty of false swearing, as provided in 15-31-
908(2)(b), MCA, that each Montana vendor has been paid in full for all goods and services purchased in connection with
the state-certified production.
___________________
______________________________________________________
Date
Signature of Corporate Officer, Partner, or Member
______________________________________________________
Printed Name and Title
*11HU0301*
*11HU0301*

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