Form R-10611 - Motion Picture Investment Tax Credit Schedule

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R -10611 (11/06)

Louisiana Department of Revenue

Motion Picture Investment Tax

Credit Schedule*

Pursuant to the Provisions of Louisiana

Revised Statute § 47:6007

PLEASE PRINT OR TYPE.

Taxpayer Name

LDR Account ID

Filing Period (mm/dd/yyyy)

LDR

Credits

Account

Credits

Remaining

State Certification

Production

Transferring

Date of

Credits

Credits sold

Claimed on

ID of

Claimed in

Credit

Number

Name

Entity

Transfer

Purchased

Sold

to GOFTD

Current

Transferring

Prior Years

Balance

Year Return

Entity

* All statutory requirements must have been met and all appropriate documentation must have been provided to the Louisiana Department of Revenue in a timely manner including but not limited to the

certification letter issued by the Louisiana Department of Economic Development and letters documenting any subsequent transfer of such credits. Failure to provide such documentation in an

appropriate and timely manner will result in the disallowance of any credits claimed. See RIB 05-001 for additional information.