Form Rpd-41290 - High-Wage Jobs Tax Credit Claim Form printable pdf download

State of New Mexico - Taxation and Revenue Department

RPD-41290

Rev. 11/30/2016

HIGH-WAGE JOBS TAX CREDIT CLAIM FORM

HOW TO USE THIS FORM. When claiming an approved high-wage jobs tax credit, this form must accompany the CRS-1, E911, or

Telecommunications Relay Service Surcharge (TRS) return(s) in which the taxpayer wants to apply the credit. Indicate the full amount

of tax liability. Do not reduce the tax liability shown on the return by the credit claimed.

Complete the High-Wage Jobs Tax Credit Application Detail Report below to show how you want to apply an approved high-wage

jobs tax credit and the amount, if any, to refund.

NOTES: Please see the instructions to determine the correct amount to apply to any report. The Department refunds excess credit

that does not appear on the report. Underpay the liability due on each return by the amount of the credit to apply. No interest will be

paid on any high-wage jobs tax credit amount refunded (Section 7-1-68 NMSA 1978). For details about false, incorrect, or fraudulent

certifications and penalties, see RPD-41288, Application for High-Wage Jobs Tax Credit, and Section 7-9G-1 NMSA 1978.

To claim the credit, attach a completed RPD-41290, High-Wage Jobs Credit Claim Form, to the return in which you want to apply the

credit on or before the due date of the return. You may apply this credit when you file your return online. Log into Taxpayer Access Point

https://tap.state.nm.us/TAP

(TAP) at

, and follow the prompts to attach this form. To send by mail, attach this form and any applicable

payments to the tax return and mail to the address on the return. For assistance claiming your approved credit, call (505) 827-0792.

New Mexico CRS identification number

Name of business

Name and phone number of contact

High-Wage Jobs Tax Credit Application Detail Report

In the columns below, enter the type of tax return, the claimed qualifying period, and the amount of high-wage jobs tax

credit to apply to each return. If you need additional space, attach a separate worksheet in the same format and enter in

line 1 below the amount of high-wage jobs tax credit to apply from all pages.

Column A

Column B

Column C

Type of Tax Return

Claimed Qualifying Period (year on return

Amount of High-Wage Jobs

(CRS-1, E911, TRS)

of January 1 to December 31 tax period)

Tax Credit To Apply

1. Total high-wage jobs tax credit applied. May not

exceed the amount on line 2 below.

2. Total approved high-wage jobs tax credit.

3. Subtract line 1 from line 2.

This is the refund amount.

I declare that I have examined this claim form including any accompanying schedules and statements, and to the

best of my knowledge and belief it is true,

correct,

and complete.

Date

Signature of Taxpayer or Agent

Title

Form Rpd-41290 - High-Wage Jobs Tax Credit Claim Form

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