Form Mpc - Refund Request Virginia Motion Picture Production Tax Credit
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1Refund Request
VIRGINIA
Tax Year
Form MPC
Virginia Motion Picture Production Tax Credit
___________
By submitting this form, a pass-through entity (PTE) may request a direct refund of the Virginia Motion Picture Production Tax Credit
instead of allocating the credit to individual partners, shareholders or members. Any credit amount refunded directly to the PTE may not
be allocated to the entity owners on the Virginia Schedule VK-1 or claimed on the Virginia income tax return of any entity owner.
Before a refund can be issued, the PTE must file the Virginia pass-through entity return, Form 502, for the current period and be registered
with the Department. Visit to register online or download and complete the registration application, Form R-1, if the
PTE has not registered or filed tax returns previously with the Department. Form 502 and the Form 502 instructions are also available on
the Department’s website.
You must attach a copy of the credit certificate issued by the Virginia Film Office.
Section I: Credit Holder Information
Legal Entity Name
FEIN
Trade Name
Contact Name
Street Address
City, State, ZIP Code
Contact Phone Number
Contact FAX Number
Contact Email
Entity Type: (Check One)
Partnership
LLC
Other ____________________________
Amount of Refund Requested _________________________
Section II: Authorized Representative Information
Name
Title
Business Name
Affiliation
Street Address
City, State, ZIP Code
Phone Number
FAX Number
Email
Section III: Declaration
I, the undersigned owner or representative authorized to act on behalf of the PTE identified in Section I, above, declare, under the
penalties provided by law, that this form (including any accompanying schedules, statements, and attachments) has been examined by
me and is, to the best of my knowledge and belief, a true, correct, and complete application, made in good faith pursuant to the income
tax laws of the Commonwealth of Virginia. I certify that all owners of the PTE agree to this request for the tax credit refund to be issued
directly to the PTE. Additionally, I certify that any credit amount that is refunded directly to the PTE will not be allocated to the entity
owners on Virginia Schedule VK-1 or claimed on any Virginia income tax return by any entity owner.
Signature of Owner or Authorized Representative
Title
Date
Printed Name
Phone Number
Mail to: Virginia Department of Taxation
Fax to: 804-786-2800
Tax Credit Unit
PO Box 715
For assistance call: 804-786-2992
Richmond, VA 23218-0715
Rev 12/13
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