Jobs And Investment Tax Credit Worksheet For Tax Year 2004 printable pdf download

JOBS AND INVESTMENT TAX CREDIT

WORKSHEET For Tax Year 2004

36 M.R.S.A. § 5215

TAXPAYER NAME: __________________________________________ EIN/SSN: __________________

Note: Owners of pass-through entities (partnerships, LLCs, S corporations, trusts, etc.) making an eligible

investment, see instructions. Also, please provide name and ID number of the pass-through entity on the

lines below.

NAME OF PASS-THROUGH ENTITY

EIN/SSN

_____________________________________________________

______________________

Part 1

1. 2004 qualified investment attributable to property located in Maine

(must be at least $5,000,000) .......................................................................................................

1 ____________

2. 2004 qualified federal credit (See instructions. The taxpayer must meet the criteria in Parts

2A & 2B below in order to claim a credit amount on this line.) ...................................................

2 ____________

3. Carryover from prior years (see instructions) ..............................................................................

3 ____________

4. Total available credit (add lines 2 and 3). Do not enter more than $500,000.

Enter here and on Form 1120ME, Schedule C, line 29b, or Form 1040ME, Schedule A, line 18 ......

4 ______________

VERIFICATION OF JOB CREATION FOR INVESTMENT IN 2004 (See instructions)

Part 2A

5. 2001 unemployment contribution wages

_______________ X .5833......................................

5 _____________

6. 2002 unemployment contribution wages

_______________ X .5833......................................

6 _____________

7. 2003 unemployment contribution wages

_______________ X .5833......................................

7 _____________

8. Enter greatest of line 5, 6 or 7 .....................................................................................................

8 ______________

9. 2004 unemployment contribution wages

_______________ X .5833......................................

9 _____________

10. New jobs credit base. Subtract line 8 from line 9 (You do not qualify for the credit if less than

$700,000) .................................................................................................................................... 10 _____________

Part 2B

11. Date qualified investment placed in service in Maine ................................................................... 11 ______________

12. Were there at least 100 new jobs created within 2 years of the date on line 11?..........................

Yes

If so, as of what date? ................................................................................................................. 12 _______________

Note: jobs created between 8/1/98 and 10/1/01 must:

a. have group health insurance coverage; ....................................................................................... 12a Yes

b. be covered by a retirement program subject to the Employee Retirement Income Security

Act of 1974 29 US Code §101-1461; ........................................................................................ 12b Yes

c. be paid higher than the average per capita wages in the labor market area of the

employment. .............................................................................................................................. 12c Yes

Jobs And Investment Tax Credit Worksheet For Tax Year 2004

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