Form It-612 - Claim For Remediated Brownfield Credit For Real Property Taxes - 2014
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1
2New York State Department of Taxation and Finance
IT-612
Claim for Remediated Brownfield Credit for
Real Property Taxes
Calendar-year filers, mark an X in the box:
Tax Law - Sections 22 and 606(ee)
Other filers enter tax period:
File a separate Form IT-612 for each Certificate of Completion (COC) with
beginning
and ending
your personal income tax return, Form IT-201, IT-203, IT-204, or IT-205.
Name(s) as shown on return
Identifying number as shown on return
Schedule A – Brownfield site identifying information
(see instructions, Form IT-612-I, for assistance)
A Enter the date of execution of the Brownfield Cleanup Agreement (BCA) for the brownfield site
(mm-dd-yyyy)
for which you are claiming the credit
.............................................................................. A
B Enter the following information as listed on the COC issued by the Department of Environmental
Conservation (DEC) for the qualified site. Submit a copy of the COC.
Site name
Site location
Municipality
County
DEC region
Division of Environmental Remediation (DER) site number Date COC was issued
C If applicable, enter the date the COC was transferred pursuant to the transfer or sale of the
qualified site. Submit a copy of the sale or transfer documentation with this form ............................ C
D Is the qualified site for which the COC was issued by the DEC located entirely within
an environmental zone (EN-Zone)? .................................................................................................... D
Yes
No
E Mark an X in the box if you received notification from the Department of State that the
qualified site is located in a Brownfield Opportunity Area ................................................................... E
Schedule B – Computation of average number of full-time employees employed by a developer and any
lessees at the qualified site
March 31
June 30
September 30
December 31
Total
Current tax year
Number of full-time employees
1 Average number of full-time employees
(if less than 25, no credit is allowed; see instructions)
..................
1
Employment number factor table
Average number of full-time employees shown on line 1
Factor
At least 25, but less than 50 ..............................................................
.25
At least 50, but less than 75 ..............................................................
.50
At least 75, but less than 100 ............................................................
.75
At least 100 .......................................................................................
1.00
Schedule C – Individuals (including sole proprietors), partnerships, and fiduciaries
2 Employment number factor
(see instructions)
...............................................................................
2
3 Eligible real property taxes
(see instructions)
.
.................................................................................
3
00
4 Enter .25
(if the qualified site is located entirely within an EN-Zone, enter 1.00)
....................................
4
5 Remediated brownfield credit for real property taxes
(multiply line 2 x line 3 x line 4)
.
....................
5
00
6 Recapture of remediated brownfield credit for real property taxes
(see instructions)
.
...................
6
00
7 Net recapture of remediated brownfield credit for real property taxes
(see instructions)
.
...............
7
00
8 Remediated brownfield credit for real property taxes after recapture
(subtract line 6 from line 5;
continue with line 9)
.
.....................................................................................................................
8
00
.
9 Credit limitation. Multiply line 1 by $10,000 and enter the result ................................................
9
00
10 Remediated brownfield credit for real property taxes claimed
(enter the lesser of line 8 or line 9)
.
...
10
00
Individuals and partnerships: Enter the line 10 amount on line 15.
Fiduciaries: Include the line 10 amount on the Total line of Schedule F, column C.
172001140094
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