Form Fp - Application For Payroll/production Credit - 2013 Page 2

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Payroll Credit
09a Payroll processed through payroll company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9a
09b Payroll paid to a loan-out company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9b
09c Payroll paid by production company on Form 1099 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9c
09 Total qualifying payroll (add lines 9a through 9c). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
10 Wages and salaries of $1,000,000 or over included in line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
11 Qualifying Massachusetts payroll. Subtract line 10 from line 9. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12 Payroll credit. Multiply line 11 by .25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Production Credit
13a Wages over $1,000,000 paid using payroll company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13a
13b Wages over $1,000,000 paid to a loan-out company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13b
13c Wages over $1,000,000 paid by production company on Form 1099 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13c
13 Wages and salaries over $1,000,000 (add lines 13a through 13c) Do not include wages used in line 11 . . . . . . . . . . . . . . . 13
14 Cost of set construction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
15 Location fees and cost of rental or purchased facilities and equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
16 Other Massachusetts production expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
17 Total Massachusetts production expenses. Add lines 13 through 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
18 Production credit. Multiply line 17 by .25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
19 Number of principal photography days for the film . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20 Number of principal photography days referenced in line 19 taking place in the Massachusetts . . . . . . . . . . . . . . . . . . . . . . 20
21 Total credit. Add lines 12 and 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Additional Requirements
Please submit the following along with this application (see instructions):
• Detailed identification of the production;
• Detailed list of all sources of funds used to finance the production as well as identification of any parent or affiliated companies;
• A list of names and addresses of entities included in lines 5 and 6 along with a list of all such expenditures;
• List of any tangible personal property for which costs were included that was not transferred or otherwise disposed of at the end of the
production;
• All required Film Production Loan-Out Affidavits.
The following requirements should be submitted in electronic format (see instructions):
• Detailed budget and cost report breaking down overall and Massachusetts expenses;
• Detailed list of all personnel and cast working in Massachusetts including dates and salaries earned while in Massachusetts;
• A complete list, including names and addresses of all vendors used on this production;
• List of all Massachusetts principal photography days, including dates and locations;
Note: If an independent auditing company produced an audit report of the expenses included in this application, please provide name
and address of the firm and attach a copy of their report.
I declare under the pains and penalties of perjury that to the best of my knowledge, the information contained herein is accurate and complete.
Signature
Date
Mail to: Massachusetts Department of Revenue, Audit Division, 200 Arlington Street, Room 4300, Chelsea, MA 02150, attn.: Film Credit Unit.

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