Schedule 4255 - Recapture Of Investment Tax Credits
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1
2
3
4Recapture of
Illinois Department of Revenue
Schedule 4255
Investment Tax
Attach this schedule to your return.
Credits
IL Attachment No. 5
Write your name as shown on your return.
Write your Social Security number (SSN) or
federal employer identification number (FEIN).
The property you are reporting on this schedule was placed in service during the tax year ending:
r
Month
Yea
Step 1: Figure your Enterprise Zone or River Edge Redevelopment Zone
Investment Credit recapture
A
B
C
D
E
F
G
H
Date property placed
Date property
Description of
Reason for
Original basis
Name of enterprise
Credit
Disqualified
in service in Illinois became disqualified
qualified property
disqualification
zone or river edge
rate
credit amount
redevelopment zone
(Col. E x Col. G)
Month
Year
Month
Year
1 a
b
c
d
e
f
2
2
Add Columns H, Lines 1a through 1f. Write the Column H total on Line 9, Column A.
Step 2: Figure your High Impact Business Investment Credit recapture
A
B
C
D
E
F
G
H
Date property placed
Date property
Description of
Reason for
Original basis
Name of the
Credit
Disqualified
in service in Illinois became disqualified
qualified property
disqualification
foreign trade zone/
rate
credit amount
subzone
(Col. E x Col. G)
Month
Year
Month
Year
3 a
.005
b
.005
c
.005
d
.005
e
.005
f
.005
4
4
Add Column H, Lines 3a through 3f. Write the Column H total on Line 9, Column B.
Step 3: Figure your Replacement Tax Investment Credit recapture
A
B
C
D
E
F
G
Original basis
Date property placed
Date property
Description of
Reason for
Credit
Disqualified
in service in Illinois became disqualified
qualified property
disqualification
rate
credit amount
(Col. E x Col. F)
Month
Year
Month
Year
5 a
b
c
d
e
6
6
Add Column G, Lines 5a through 5e. Write the Column G total on Line 9, Column C.
This form is authorized as outlined by the Illinois Income Tax Act. Disclosure of this
information is REQUIRED. Failure to provide information could result in a penalty.
Schedule 4255 (R-12/12)
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