Form Dr 0078a - Pass-Through Entity Enterprise Zone Credit Distribution Report

Colorado department oF reVenUe

DR 0078a (12/22/11)

DenveR CO 80261-0005

pass-throUgh entity enterprise Zone Credit distribUtion report

This form is required for all pass-through entities that distribute Enterprise Zone credits to their investors/owners. Complete all relevant fields, including at least one of the ID numbers in the shaded area. List the dollar amount for each credit passed

to that taxpayer. Submit this form with your enterprise zone certification form(s): DR 0074, DR 0075, DR 0076 and DR 0077.

FEIN

Pass-through entity name

Colorado account number

New Business

Enhanced Rural

Vacant Commercial

Colorado Account

EZ Investment

Enhanced Rural

Ag Processing

NBF Health

Contribution to EZ

Research and

FEIN

Social Security Number

Job Training Credit

Facility (NBF)

Ag Processing

Building Rehab

Taxpayer name

Number (CAN)

Tax Credit

NBF Credit

NBF Credit

Insurance Credit

Admin Credit

Development Credit

Jobs Credit

NBF Credit

Credit

total

$

$

$

$

$

$

$

$

$

$