Form Rpd-41371 - Application For Veteran Employment Tax Credit - State Of New Mexico Taxation And Revenue Department

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STATE OF NEW MEXICO
RPD-41371
Int. 09/04/2012
TAXATION AND REVENUE DEPARTMENT
APPLICATION FOR VETERAN EMPLOYMENT TAX CREDIT
Who May Use This Form. Form RPD-41371, Application for the Veteran Employment Tax Credit, is to be used by eligible
employers to apply for the veteran employment tax credit.
How to Apply For This Tax Credit: To apply for the credit you must complete Form RPD-41371, Application for Veteran
Employment Tax Credit, and attach a Form RPD-41370, Certification of Eligibility for the Veteran Employment Tax Credit,
for each qualified military veteran included in the total credit which is summarized on the application, Form RPD-41371. An
application can include multiple certifications for multiple qualified military veterans for the tax year of the application. Submit
the application and certifications to the Taxation and Revenue Department for approval prior to claiming the credit. Once ap-
proved, you may claim the credit against your personal or corporate income tax due by attaching Form RPD-41372, Veteran
Employment Tax Credit Claim Form, to the tax return for the tax year in which you employ the qualified military veteran. The
amount of the approved veteran employment credit that exceeds your income tax or corporate income tax liability in the tax-
able year in which the credit is claimed will not be refunded, but may be carried forward for up to three years.
For status of the application, call (505) 827-6811.
Mail to: Taxation and Revenue Department, P.O. Box 5418, Santa Fe, NM 87502-5418.
New Mexico CRS identification no.
Name of eligible employer
Physical address
City, state and ZIP code
Mailing address, if different
City, state and ZIP code
Name of contact
Phone number
E-mail address
1. Enter the employer’s tax year in which the eligible employment took place.
through
(mm-dd-yyyy)
(mm-dd-yyyy)
If the veteran was employed across multiple tax years, include only certifications for qualified periods of employment that
occurred during this tax year. A separate application must be submitted for qualified periods of employment that occurred
in a different tax year.
Total veteran employment tax credit.
2. Enter the number of certifications* attached:
_______________________
A certification for each military veteran whose qualified period of employment
occurred during the tax year of this application must be attached.
$
3. Enter the total veteran employment tax credit requested:
_______________________
Enter the sum of the tax credit requested (from line 10) from each certification
included in this application.
Attach Form(s) RPD-41370, Certification of Eligibility for the Veteran Employment Tax Credit.
*
I declare I have examined this application, including attachments, and to the best of my knowledge and belief it is true, correct and
complete.
Taxpayer Authorized Signature
Date
FOR DEPARTMENT USE ONLY
Authorized by the New Mexico Taxation and Revenue Department.
Approved by:
Title:
Telephone number:
Date:
Veteran Employment Tax Credit amount approved: $
Claim number:

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