Form Rpd-41167 - Application For New Mexico Investment Credit
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2RPD-41167
State of New Mexico - Taxation and Revenue Department
Rev. 11/14/2011
APPLICATION FOR NEW MEXICO INVESTMENT CREDIT
Mail this form and all required attachments to:
Taxation and Revenue Department
ATTN: Director's Office
P.O. Box 8485
Albuquerque, New Mexico 87198-8485
For the status of the credit application call (505) 841-6478.
Name of Business
Address
City
State
ZIP Code
New Mexico CRS Identification Number
Name of Contact Person
Telephone Number
(
)
I. QUALIFYING INFORMATION
1.
Calendar year in which qualified equipment was purchased or introduced into New Mexico: ___________________________
2.
Attach a detailed schedule showing the types of equipment, the date placed in service and the depreciable basis for federal tax
purposes. Your detailed schedule must be reconciled to your attached copy of Federal Form 4562.
3.
Description of your manufacturing operation:________________________________________________________________
__________________________________________________________________________________________________
4.
a.
Number of new full-time employees hired. (Itemize on Form RPD-41168, Schedule A)
___________
b.
Number of full-time employees employed one year prior to the date of this claim:
___________
II. CALCULATION OF CREDIT CLAIMED
A.
The adjusted basis of equipment on which credit is claimed:
$ _________________________
B.
Investment credit claimed (Line A x 5.125%)
$ _________________________
III. I CERTIFY THAT:
•
The equipment on which credit is claimed on this application has been incorporated into the taxpayer's manufacturing
operation.
•
The equipment on which credit is claimed on this application is q owned by the taxpayer or q owned by the United States,
the State of New Mexico or a political subdivision thereof and leased to the taxpayer.
•
The equipment on which credit is claimed on this application does not include any property for which the taxpayer claims a
credit against compensating tax pursuant to Section 7-9-79 NMSA 1978.
•
The equipment on which credit is claimed on this application does not include any property previously used in New Mexico
and was not previously approved for a credit under the Investment Credit Act pursuant to Section 7-9A-6 NMSA 1978.
I declare I have examined this application, including accompanying invoices, schedules and/or statements, and to the best of my
knowledge and belief this application is true, correct and complete.
_________________________________________________________________________________________
Authorized Signature
Title
Date
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