Form Rev-984 - Pennsylvania Organ & Bone Marrow Donor Tax Credit Page 2
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2PENNSYLVANIA ORGAN & BONE MARROW DONOR TAX CREDIT APPLICATION INSTRUCTIONS
PER ACT 65 of 2006
GENERAL INSTRUCTIONS:
Compensation for the period of absence does not include
bonuses paid for prior (or future) performance of services
To claim the PA Organ & Bone Marrow Donor Tax Credit, a taxpayer must
during the period of absence, sales commissions paid for
provide one or more paid leaves of absence to employees for the specific
prior performance of services during the period of absence,
purpose of donating organ or bone marrow. The qualifying leave of
non-cash compensation paid during the period of absence
absence period per employee cannot exceed five days.
(such as personal use of company vehicles), stock options
For purposes of the PA Organ & Bone Marrow Donor Tax Credit, a
exercised during the period of absence, distributions or
“business firm” is defined as an entity subject to PA personal income tax,
payments of previously deferred compensation paid during
corporate net income tax, capital stock/foreign franchise tax, bank and
the period of absence, payments for employee health plans,
trust company shares tax, title insurance companies shares tax,
reimbursements
of
expenses
and
other
items
of
insurance premiums tax, or mutual thrift institutions tax. Business firms
compensation not included in the normal compensation of
also include any natural person as such or as a member of a partnership
an employee.
or a shareholder in a PA S corporation, as well as estates and trusts and
beneficiaries of estates and trusts.
Line 4. Enter total employee compensation paid for the leaves of
absence.
A taxpayer must apply for the PA Organ & Bone Marrow Donor Tax Credit
by the 15th day of the fourth month following the close of the business
Line 5. Enter the temporary help, Federal Employee Identification
firm’s taxable year. The department will notify all taxpayers of the
Number (FEIN) or SSN, Reference Number, Beginning Date of
approved amount of PA Organ & Bone Marrow Donor Tax Credit. The
Service, Ending Date of Service and Temporary Help Paid per
taxpayer may apply the approved credit against PA personal income tax,
employee referenced above.
corporate net income tax, capital stock/foreign franchise tax, bank/trust
Temporary Help – Agency or, if not using an agency,
company shares tax, title insurance companies shares tax, insurance
individual hired to cover the leave of absence of the
premiums tax, or mutual thrift institutions tax for the taxable year in
employee donating an organ or bone marrow.
which the leave of absence was granted. Any unused credits may be
carried over to no more than the three succeeding taxable years. Credits
Reference Number – Line number associated with the
may not be carried back and are not refundable. The credit cannot be
employee for which this temporary help is engaged to cover.
applied against any tax withheld by an employer from an employee
(e.g. If Temporary Help is a replacement for Employee 3a
under Article III of the Tax Reform Code.
listed above, enter 3a.)
A pass-through entity is a partnership or PA S corporation as defined in
Temporary Help Paid – Invoice amount paid to a temporary
Section 301 of the Tax Reform Code. The PA Organ & Bone Marrow Donor
help agency or gross compensation paid to an individual.
Tax Credit applicable to a pass-through entity may be claimed by each
Line 6. Enter total temporary help paid for the leaves of absences of the
partner, member or shareholder on a pro-rata basis in proportion to the
employees donating an organ or bone marrow.
partner, member or shareholder’s portion of the pass-through entity’s
income.
Line 7. Organ & Bone Marrow Donor Tax Credit before Apportionment
(Line 4 plus Line 6)
A business firm that is taxed in more than one state is required to
apportion the credit to determine the proportion of the credit that may
Line 8. Apportionment Factor – Apportionment is determined by
be claimed in Pennsylvania. The apportionment of the credit is
multiplying the available credit by a payroll factor. The numerator
determined by multiplying the available credit by a payroll factor. The
of the factor is the total amount paid in the commonwealth
numerator of the factor is the total amount paid in the commonwealth
during the tax period for compensation and the denominator of
during the tax period for compensation and the denominator of which is
which is the total compensation paid everywhere during the tax
the total compensation paid everywhere during the tax period.
period. The apportionment factor is equal to 1.0 for business
firms whose total compensation paid is entirely in the
LINE INSTRUCTIONS:
Commonwealth of Pennsylvania.
Enter the business firm’s name, address, Revenue ID/SSN and
Line 9. PA Organ & Bone Marrow Donor Tax Credit (Line 7 multiplied by
Federal Employer Identification Number.
Line 8, Apportionment Factor)
Check the block associated with the structure that best identifies
the business firm (check more than one if applicable).
REQUIRED ATTACHMENTS:
Line 1. Enter the beginning and ending dates of the business firm’s tax
For each employee identified on Line 3, include:
period.
1. Employee pay statement for absence period and periods
Line 2. Enter the number of employees donating an organ or bone
immediately preceding and following the absence period.
marrow during the tax period.
2. Letter from a physician describing the procedure and dates of
Line 3. Enter the employee name, Social Security number, Beginning
absence; must reference the employee’s full name.
Date of Leave of Absence, Ending Date of Leave of Absence and
For each temporary help occurrence identified on Line 5, include:
Gross Compensation per employee donating an organ or bone
1. Invoice statement from temporary help agency; must show cost
marrow during the tax period.
per day, not to exceed five days.
Leave of Absence – The period, not exceeding five working
days or the hourly equivalent of five working days per
2. Pay statement to temporary help employee; must list beginning
employee, during which a business firm provides a paid
and ending date of service, not to exceed five days.
leave of absence to the employee for the purpose of organ
The department may contact the taxpayer for additional
or bone marrow donation. The leave of absence does not
documentation necessary to verify the tax credit.
include a period during which an employee utilizes any
Send completed applications (including signature) to:
annual leave or sick days that the employee has been given
by the employer.
Bureau of Corporation Taxes
CD&S Division - OBMD Unit
Employee Compensation - Gross compensation for purposes
of calculating the credit includes salaries and other regular
PO Box 280700
hourly wage payments paid for the period of absence.
Harrisburg, PA 17128-0700
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