Form Ct-601 - Claim For Ez Wage Tax Credit - 2013 Page 3
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4CT-601 (2013)
Page 3 of 4
Part 3 – Computation of EZ wage tax credit for qualified employees not included in Schedule B, Parts 1 or 2
(see instructions)
Current tax year
March 31
June 30
September 30
December 31
Total
Number of qualified employees
12 Average number of qualified employees
.. .
12
(round to two decimal places; do not round to whole number)
1,500.00
13 Wage tax credit per employee ..........................................................................................................
13
14 Amount of EZ wage tax credit for qualified employees
14
(multiply line 12 by line 13)
............................
List below the name and social security number of each employee included in the computation of the EZ wage tax credit on
line 14. (Attach additional sheets if necessary.)
Employee’s name
Social security number
Employee’s name
Social security number
Part 4 – For taxpayers certified in an IZ; Computation of EZ wage tax credit for qualified employees not included in
Schedule B, Part 1 or 2 who received wages in excess of $40,000 for the tax year
(see instructions)
Current tax year
March 31
June 30
September 30
December 31
Total
Number of qualified employees
15 Average number of qualified employees
15
(round to two decimal places; do not round to whole number)
..
2,000.00
16 Wage tax credit per employee ..........................................................................................................
16
17 Amount of EZ wage tax credit for qualified employees
(multiply line 15 by line 16)
17
............................
List below the name and social security number of each employee included in the computation of the EZ wage tax credit on
line 17. (Attach additional sheets if necessary.)
Employee’s name
Social security number
Employee’s name
Social security number
Part 5 – Computation of EZ wage tax credit for the current tax year
(see instructions)
18 EZ wage tax credit for the current tax year
18
(add lines 8, 11, 14, and 17)
............................................
19 EZ wage tax credit from partnerships
19
(enter amount from line 20b)
....................................................
20a Total EZ wage tax credit for current tax year
20a
(add lines 18 and 19; enter here and on line 22)
..............
Part 6 – Partnership information
(attach additional sheets if necessary)
Name of partnership
Taxpayer ID
Amount of credit
Total from additional sheet(s), if any................................................................................................................
20b Total credit amount from partnership(s)
..................................................... 20b
(enter here and on line 19)
Schedule C – Amount of EZ wage tax credit available for the current tax year
(see instructions)
21 EZ wage tax credit carryforward from preceding tax year ..............................................................
21
22 EZ wage tax credit computed for the current tax year from line 20a ..............................................
22
23 EZ wage tax credit available for current tax year
23
(add lines 21 and 22)
.............................................
460003130094
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