Form Tel-2 - Telework Expenses Tax Credit Confirmation Application

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VIRGINIA
Telework Expenses Tax Credit
Tax Year
Form TEL-2
Confirmation Application
___________
File by April 1*
This credit must be approved before being claimed on your return.
See the instructions for details.
Name
FEIN
Trading As
Contact Name
Street Address
Office Use Only
City, State, ZIP Code
Phone Number
FAX Number
Email
Entity Type: (Check One)
Sole Proprietor
C Corporation
S Corporation
Partnership
LLC
Other
Form TEL-1, the Telework Expenses Tax Credit Reservation Application, must have been filed between September 1 and
October 31 of the year preceding the taxable year for which the tax credit is earned using anticipated telework expenses.
The Department provided a reservation letter to all qualified taxpayers stating the tentative credit amount by December 31.
Form TEL-2, the Telework Expenses Tax Credit Confirmation Application, must be filed by April 1 of the year following the
calendar year when the eligible expenses were incurred. Also, complete the Telework Expenses Tax Credit Worksheet.
Include the Telework Expenses Tax Credit Worksheet and a copy of your reservation letter when submitting Form TEL-2. If
you did not fill out and receive a reservation letter after submitting Form TEL-1, you cannot submit Form TEL-2. Once Form
TEL-2 is approved, the Department will send a certification letter by June 30 providing the amount of the Telework Expenses
Tax Credit that can be claimed on your Virginia return.
1. Number of eligible teleworking employees ...................................................................... ________________________
$
.00
2. Telework expenses (up to $1,200 per teleworking employee) .........................................
____________________
$
.00
3. Telework assessment costs. Enter total expenses or $20,000, whichever is less ...........
____________________
$
.00
4. Total credit requested. Add Line 2 and Line 3 or enter $50,000, whichever is less. ........
____________________
I certify that:
• The telework expenses outlined above would not have been incurred but for the availability of this credit;
• The business outlined above is based in Virginia;
• The telework agreement between the employer and the participating employee is effective on or after July 1, 2012;
• No deduction for telework expenses will be claimed on the Virginia return;
• If a deduction for expenses is claimed on the federal return, an offsetting addition will be claimed on the Virginia return;
• No other income tax credit will be claimed on the Virginia return for the same expenses; and
• No financial incentives from the Telework!VA program will be used for the same expenses.
Under penalty of law, I have read and understand the limitations and restrictions of this credit.
Authorized Signature
Title
Date
Printed Name
Phone Number
Email Address
FAX Number
*File Form TEL-2, the Telework Expenses Tax Credit Worksheet, and a copy of your reservation letter by April 1
for expenses incurred during the preceding year.

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