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SCHEDULE KEOZ-SP

For taxable year ended

*1100020239*

__ __ / __ __

41A720-S41 (10-11)

Mo.

Yr.

Commonwealth of Kentucky

OMPUTATION

CHEDULE

DEPARTMENT OF REVENUE

(FOR A KEOZ PROJECT OF A PASS-THROUGH ENTITY)

➤ See instructions.

➤ Attach to Form 720S, 765 or 765-GP .

KRS 154.23-005 to 080

Name of Pass-through Entity

Federal Identification Number

Kentucky Corporation/LLET

Account Number

__ __ __ __ __ __

__ __ __ __ __ __ __ __ __

Location of Project

Activation Date of KEOZ

Economic Development

Incentive Agreement

Project Number

City

County

Mo.

Day

Yr.

PART I—Computation of KEOZ Tax Credit and Tax Due

1. Kentucky taxable income on KEOZ project (see instructions) ...........................................................

2. Net operating loss deduction on KEOZ project .................................................................................

2 (

)

3. Kentucky taxable income on KEOZ project after net operating loss deduction

(line 1 less line 2) ...................................................................................................................................

4. Income tax on amount from line 3:

Taxable Net Income

Rate

Tax

(a) First $3,000 ........................

(b) Next $1,000 ........................

(d) Next $3,000 ........................

(e) Over $8,000 up to $75,000

5.8%

(f) Over $75,000.......................

(g) Total income tax liability of KEOZ project (add lines 4(a) through 4(f)) ..................................... 4(g)

5. LLET on KEOZ project (see instructions). Not applicable for Form 765-GP ......................................

6. LLET credit allowed (line 5 less $175, but not more than line 4(g)). Not applicable for

Form 765-GP ..........................................................................................................................................

7. Total tax on KEOZ project (lines 4(g) and 5 less line 6) ......................................................................

8. Limitation (Column G from Schedule KEOZ-T) ...................................................................................

9. Enter the lesser of line 7 or line 8 as either:

(a) KEOZ tax credit .............................................................................................................................. 9(a)

(b) Estimated tax payment and complete election in Part II ............................................................. 9(b)

10. If line 7 is larger than line 9(a) or 9(b), enter difference here as a liability of the

pass-through entity. (Any pass-through entity reflecting a tax liability, complete

Tax Payment Summary below and remit payment.) ..........................................................................

PART II—Estimated Tax Election

In accordance with KRS 141.401(4)(b),

Name of Pass-through Entity

elects for the taxable year ended

, in lieu of the

tax credit, to have an amount equal

KEOZ

to the lesser of line 7 or line 8 above applied as an estimated tax payment.