Jobs And Investment Tax Credit Worksheet - 2015
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1
2JOBS AND INVESTMENT TAX CREDIT
WORKSHEET FOR TAX YEAR 2015
36 M.R.S. § 5215
TAXPAYER NAME: _____________________________________ EIN/SSN: ________________
Note: Owners of pass-through entities (such as partnerships, LLCs, S corporations and trusts) making an eligible
investment, see instructions. Enter name and ID number of the entity on the lines below. Also enter your ownership
percentage in the pass-through entity for the tax year.
OWNERSHIP
NAME OF PASS-THROUGH ENTITY
EIN/SSN
PERCENTAGE
_______________________________________________
_______________________
________ %
Part 1
1.
2015 qualifi ed investment attributable to property located in Maine (must be at least $5,000,000) ........ 1. ___________________
2.
Credit claimed. Enter 2015 qualifi ed federal credit (See instructions. The taxpayer must meet the
criteria in Parts 2A & 2B below in order to claim a credit amount on this line.)......................................... 2. ___________________
3.
Carryover from prior years (see instructions) .......................................................................................... 3. ___________________
4.
Total credit available (add lines 2 and 3). The amount of credit applied to this year’s tax may not
exceed $500,000. Enter here and on Form 1120ME, Schedule C, line 29b, or Form 1040ME,
Schedule A, line 20 or Form 1041ME, Schedule A, line 16 ..................................................................... 4. ___________________
Unused credit amounts may be carried forward for up to six years.
VERIFICATION OF JOB CREATION FOR INVESTMENT IN 2015 (See instructions)
Part 2A
5.
2012 unemployment contribution wages .................................................................................................. 5. ___________________
6.
2013 unemployment contribution wages .................................................................................................. 6. ___________________
7.
2014 unemployment contribution wages .................................................................................................. 7. ___________________
8.
Enter greatest of lines 5, 6 or 7................................................................................................................. 8. ___________________
9.
2015 unemployment contribution wages (The unemployment compensation may be for 2015, 2016 or
2017 - see instructions) ............................................................................................................................ 9. ___________________
10. New jobs credit base. Subtract line 8 from line 9 (You do not qualify for the credit if less than
$1,200,000)............................................................................................................................................. 10. ___________________
Part 2B
11. Date qualifi ed investment placed in service in Maine .............................................................................11. ___________________
12. Were there at least 100 new jobs created within two years of the date on line 11? ............................... 12.
Yes
No
12a. If so, as of what date? .......................................................................................................................... 12a. ___________________
Rev. 08/15
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