Schedule Verb - Kentucky Voluntary Environmental Remediation Tax Credit
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1
2Taxable Year Ending
SCHEDULE VERB
*1500030229*
__ __ / __ __
41A720VERB (10-15)
Mo.
Yr.
Commonwealth of Kentucky
V
E
OLUNTARY
NVIRONMENTAL
DEPARTMENT OF REVENUE
R
T
C
EMEDIATION
AX
REDIT
➤ See instructions.
KRS 141.418
➤ Attach to Form 720, 720S, 725, 740, 740-NP , 741, 765 or 765-GP .
Name of Entity
Federal Identification Number
Taxed as:
Corporation
Limited Liability Pass-through Entity
Kentucky Corporation/LLET Account Number
General Partnership
Individual
Other _____________________________________________
Location of Remediation Property
County Location
Department of Revenue Use Only
PART I—Computation of Allowable Tax Credit
/
/
1. Date certified ...........................................................................................................
1
2. Certified remediation expenditures (not to exceed $150,000) ............................
2
00
3. Maximum allowable tax credit each tax year (line 2 multiplied by 25% (.25)) ..
3
00
By: ________________________________________________
Date: ______________________________
PART II—Taxpayer’s Certification
I, the undersigned and authorized representative, declare under the penalties of perjury, that the expenditures incurred
at the qualifying voluntary environmental remediation property were not financed through a public grant program or the
petroleum storage tank environmental assurance fund.
Signature
Title
Date
PART III—Current Year Credit
00
1. LLET Credit—Enter on Schedule TCS, Part II, Column E .........................................
1
2. Corporation Income Tax Credit—Enter on Schedule TCS, Part II, Column F ..........
2
00
3. Individual Income Tax Credit—Enter on Form 740, 740-NP or 741 .........................
3
00
PART IV—Amount of Credit Claimed
A
B
C
Taxable Year Credit Taken
Balance of VERB
Amount of Credit Used
(Month/Year)
LLET
Income Tax
LLET
Income Tax
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