Rural Area Application For B&o Tax Credit On New Employees
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1
2Washington State
Rural Area Application
Department of Revenue
Taxpayer Account Administration
for B&O Tax Credit on New Employees
Special Credits & Assessments
Team
PO Box 47476
Reset This Form
Olympia WA 98504-7476
Application for tax credits must be made within 90 days after the actual hiring of qualified employment positions. A new application
must be submitted after each group of four consecutive quarters that you project employment to increase over 15%. Positions hired
after the end of four consecutive calendar quarters are not considered for this credit. Credit for a position may not be received under
both this program and the Software B&O Job Credit Program or the International Services Job Credit Program. This application
reflects legislative changes of House Bill 1566 effective January 1, 2008.
Business Identification
Name of Business
Name of Contact Person (all correspondence will be directed to this person)
Address
Telephone Number
City
State
Zip Code
-
-
Department of Revenue Tax Reporting Account Number
-
Department of Employment Security Identification Number
Location of the Facility for Which Job Credits are Being Sought
Please complete one application for each separate facility that is expanding positions.
Check one:
County
Rural County
Community Empowerment Zone
Street Address
City
State
Zip Code
Does the applicant operate in other Washington locations?
Yes
No
Business Activity to be Conducted at This Business Facility
If additional space is needed please attach additional pages.
Describe your manufacturing activity:
Describe your research and development activities, if applicable:
Is the applicant engaged in the power and light business, other than in-house co-generation?
Yes
No
General Information
If this is to be a new facility, what is the estimated cost of the project?
Check one:
Cost of structure
Business is new
Cost of equipment
Business is expanding
Total
REV 41 0077e (3/20/12)
Page 1
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