310
NEW JERSEY CORPORATION BUSINESS TAX
FORM
(07-15, R-09)
HMO ASSISTANCE FUND TAX
2015
FOR TAXABLE PERIODS ENDING ON AND AFTER JULY 31, 2014
Name as Shown on Return
Federal ID Number
NJ Corporation Number
READ THE INSTRUCTIONS ON THE REVERSE SIDE BEFORE COMPLETING THIS FORM.
PART I
QUALIFYING ASSESSMENTS
Enter the amount of each qualifying assessment and the date each assessment was paid.
Assessment Amount/Date
Assessment Amount/Date
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
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PART II
CALCULATION OF THE ALLOWABLE CREDIT AMOUNT
1. Enter the total qualifying assessment amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.
2. Total available credit amount - enter 50% of line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.
3. Maximum annual credit amount - enter 20% of line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.
4. Enter tax liability from page 1, line 9 of CBT-100 or BFC-1, or line 4 of CBT-100S . . . . . . . . . . . . . . . .
4.
5. Enter the required minimum tax liability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.
6. Subtract line 5 from line 4 - if less than zero, enter zero . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6.
7. Enter 20% of line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7.
8
8.
Enter the lesser of line 3 or line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Tax Credits taken on the current year’s return:
a)
______________________________
______________________________
b)
______________________________
______________________________
c)
______________________________
______________________________
d)
______________________________
______________________________
Total
9.
10. Subtract line 9 from line 8. If the result is less than zero, enter zero . . . . . . . . . . . . . . . . . . . . . . . . . .
10.
11. Allowable credit for the current tax period - Enter the lesser of line 7 or line 10 here and on
Schedule A-3 of the CBT-100, the CBT-100S or the BFC-1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11.