New Markets Capital Investment Credit Worksheet For Tax Year 2015

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NEW MARKETS CAPITAL INVESTMENT CREDIT
WORKSHEET FOR TAX YEAR 2015
36 M.R.S. § 5219-HH
FOR ELIGIBLE INVESTMENTS MADE DURING TAX YEARS BEGINNING IN 2012 AND 2013
Note: You are eligible to claim a 2015 New Markets Capital Investment Credit only if you are a holder of a Maine New Markets
Capital Investment Program Tax Credit Certifi cate issued by the Finance Authority of Maine (“FAME”). The certifi cate must
have been issued with respect to a qualifi ed equity investment made during your tax year beginning in 2012 or 2013 (that
is, the 3rd or 4th credit allowance date must fall within your tax year beginning in 2015). To claim the credit, you must
enclose a copy of the certifi cate with the completed credit worksheet.
Enter your name and EIN/SSN:
NAME ___________________________________________________________________________________________
EIN/SSN _________________________________________________________________________________________
Note: In the case of pass-through entities (such as partnerships, LLCs, S corporations, and trusts) making eligible
investments, the partners, members, shareholders, benefi ciaries, or other owners are allowed a credit in proportion
to their respective interests in these entities or in accordance with an executed agreement among the owners. Enter
the name and ID number of the entity on the lines below. Also enter your ownership percentage in the pass-through
entity or, if applicable, your percentage interest in the credit in accordance with an executed agreement among the
owners.
NAME OF PASS-THROUGH ENTITY
EIN/SSN
OWNERSHIP
PERCENTAGE
_________________________________________________
__________________
_______________ %
Prior Certifi cate Holder Information (only applicable if a transfer of the Maine New Markets Capital Investment Program
Certifi cate has occurred; see instructions):
Name of prior certifi cate holder _______________________________________________________________________
EIN of prior certifi cate holder _________________________________________________________________________
1.
Purchase price of qualifi ed equity investments made during your tax year beginning in
2012 (see instructions) ............................................................................................................ 1. __________________
2.
Credit for Year 4 (line 1 multiplied by .08) ............................................................................... 2. __________________
3.
Purchase price of qualifi ed equity investments made during your tax year beginning in
2013 (see instructions) ............................................................................................................ 3. __________________
4.
Credit for Year 3 (line 3 multiplied by .07) ............................................................................... 4. __________________
5.
Credit carried forward from 2014 (2014 credit worksheet, line 4) ........................................... 5. __________________
6.
Credit available this year. Add lines 2, 4 and 5 ...................................................................... 6. __________________
7.
Credit claimed this tax year (this amount is refundable; see instructions). Enter the amount
being claimed here and on either Form 1120ME Schedule C, line 30b; Form 1040ME
Schedule A, line 4; or Form 1041ME Schedule A, line 3 ........................................................ 7. __________________
8.
Credit carried forward to tax year 2016 (line 6 minus line 7) .................................................. 8. __________________
Unused credit amounts may be carried forward for up to 20 years.
Rev. 08/15

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