Form 775n - Nebraska Employment And Investment Growth Act Credit Computation
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8RESET FORM
NEBRASKA EMPLOYMENT AND INVESTMENT GROWTH ACT CREDIT COMPUTATION
FORM
for use with Forms 1120N, 1065N, 1120-SN, 1120NF, 1041N, and 1040N
nebraska
775N
• Schedule I is required for all projects with applications filed after April 30, 1996
department
Taxable year beginning
,
and ending
,
of revenue
Name as Shown on Return
Social Security or Nebraska I.D. No.
Federal Identification Number
Type of Return
1120-SN
1041N
1120N
1065N
1120NF
1040N
Project Name
Year of Application
Option Chosen in Employment and Investment Growth Act Agreement
$3,000,000 investment and 30 new employees
$20,000,000 investment
Project Location
$10,000,000 investment and 100 new employees
QUALIFICATION LEVELS
First Year ________
Second Year ________
Third Year ________
Fourth Year ________
Corrected
Corrected
Corrected
Corrected
1
For First Year Only (check appropriate box)
Application
Entitlement
Carryover
(If corrected,
(If corrected,
(If corrected,
(If corrected,
Taxable year ending (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
attach explanation)
attach explanation)
attach explanation)
attach explanation)
2 Total cumulative net investment in the project at taxable year end. (Qualified
$
$
$
$
property placed in service on or after the date of application, net of: sales tax,
retirements of qualified property, and expired or cancelled qualified leases) . . . . . .
2
3 Current year investment of qualified property (net of sales tax paid) (line 5 from
Worksheet C-2 in instructions) (for 1987 applications, use Worksheet C-1) . . . . . .
3
4 Number of new employees at taxable year end (see Worksheet A-2 in
instructions) (for 1987 applications, use Worksheet A-1) . . . . . . . . . . . . . . . . . . . .
4
5 Total refundable sales and use tax paid at the project at year end (cumulative) . .
5 $
$
$
$
EMPLOYEE AND WAGE INFORMATION
6 Enter in column A the last day of the calendar quarter
(A)
(B)
(C)
(D)
(E)
prior to the application date and in columns B through E
the last day of each subsequent tax year . . . . . . . . . . . . .
6
7 Total number of actual employees in Nebraska at each
date (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
8 Average annual wage per employee for jobs created
$
$
$
$
in Nebraska after the application date . . . . . . . . . . . . . . . .
8
APPLICATION OF CREDITS
9 Allowable compensation credit of current taxable year (see Worksheet B-2 in
$
$
$
$
instructions) (for 1987 applications, use Worksheet B-1) . . . . . . . . . . . . . . . . . . . .
9
10 Allowable investment credit of current taxable year (see Worksheet C-2 in
instructions) (for 1987 applications, use Worksheet C-1) . . . . . . . . . . . . . . . . . . . . 10
11 Total allowable credit of current taxable year (total of lines 9 and 10) . . . . . . . . . . 11 $
$
$
$
12 Amount of credit carried forward from previous year . . . . . . . . . . . . . . . . . . . . . . . . 12
13 Amount of distributed credit received during the current year . . . . . . . . . . . . . . . . . 13
14 Total available credit in current year (total of lines 11, 12, and 13) . . . . . . . . . . . . . 14 $
$
$
$
15 Amount of credit taken in current year against income tax liability (enter amount
here and on appropriate line of Form 3800N) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
16 Amount of credit used to receive sales and use tax refunds on other
property used at the project (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
17 Amount of credit distributed to partners, S corporation shareholders, or
certain fiduciary beneficiaries (line 2 on Schedule ) . . . . . . . . . . . . . . . . . . . . . . . 17
18 Ending balance of total credit to be carried forward to following year’s line 12
$
$
$
$
(line 14 minus lines 15, 16, and 17) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
ATTACH THIS FORM TO NEBRASKA INCOME TAX RETURN
printed on recycled paper
8-426-1987 Rev. 4-2004 Supersedes 8-426-1987 Rev. 5-2002
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