K-59
KANSAS
HIGH PERFORMANCE INCENTIVE PROGRAM (HPIP) CREDITS
(Rev. 7/12)
For the taxable year beginning _________________ , 20____ ; ending _________________ , 20____ .
Name of taxpayer (as shown on return)
Social Security Number or Employer ID Number (EIN)
If partner, shareholder or member, enter name of partnership, S corporation, LLC or LLP
Employer ID Number (EIN)
PART A – GENERAL INFORMATION
1. Enter the period for which you were HPIP certified by the Secretary of Commerce.
1. _ _ / _ _ /_ _
thru
_ _ / _ _ /_ _
2. Enter your HPIP certification number.
2. ________________________
PART B – HPIP TRAINING AND EDUCATION CREDIT
3. Total qualified cash investment in training and education.
3. ________________________
4. Total amount expended for payroll during the period specified.
4. ________________________
5. Multiply line 4 by 2%.
5. ________________________
6. Amount of credit subject to limitation (subtract line 5 from line 3).
6. ________________________
7. Total credit for amount invested (the lesser of line 6 or $50,000).
7. ________________________
8. Enter your proportionate share percentage.
8. ________________________
9. Amount of credit allowable for training and education.
9. ________________________
PART C – HPIP INVESTMENT CREDIT
10. Address location of qualified business facility:
________________________________________________________________
____________________________________________
Street Address
City
11. Complete the following investment schedule for the 1st qualifying year:
(1)
(2)
(3)
Enter Business Entity Tax
Base Year: __ __ __ __
1st Qualifying Year: __ __ __ __
Filing Period By Month
Monthly Base Investment
Monthly Qualifying Investment
a
b
c
d
e
f
g
h
i
j
k
l
m TOTAL
n
Average Investment
o
Capitalized Rents
p
TOTAL
q
Base
r
Average Qualified Investment
s
Minimum Investment Allowed
Enter $50,000 or $1,000,000 (see instructions)
t
Qualified Business Facility Investment
u
INVESTMENT CREDIT (10% of line 11t)