Schedule Keoz-T - Kentucky Tracking Schedule For A Keoz Project

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SCHEDULE KEOZ-T
*1500030240*
41A720-S42 (10-15)
Commonwealth of Kentucky
DEPARTMENT OF REVENUE
T
S
RACKING
CHEDULE
F
KEOZ P
OR A
ROJECT
➤ See instructions.
KRS 154.23–005 to 080
➤ Attach to Schedule KEOZ or KEOZ-SP .
Name of Entity
Entity Type
Corporation
Federal Identification Number
Kentucky Corporation/LLET
Limited Liability Pass-through Entity
Account Number
General Partnership
________________________
__ __ __ __ __ __ __ __ __
__ __ __ __ __ __
Other
Location of Project
Activation Date of KEOZ
Economic Development
Incentive Agreement
Project Number
_ _ / _ _ / _ _
City
County
Mo.
Day
Yr.
Check One:
Service or Technology Agreement
Tax Incentive Agreement
Note that Columns B and C apply only to service or technology agreements and Columns D and E apply only to tax
incentive agreements.
A
B
C
D
E
F
G
H
Excess
50 Percent
Taxable
Employee Wage
Debt Service
Balance of
Debt
KEOZ Tax
KEOZ Tax
of Approved
Year
Assessments
Payment
Approved Costs
Service Payment
Credit Limitation
Credit Claimed
Annual Rental
Ended
Withheld
(Col. G–Col. H)
Payments
from Prior Year)
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