Form Ri-107 - Tax Incentives For Employers - 2012
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1
2State of Rhode Island and Providence Plantations
Form RI-107
2012
DEPARTMENT OF REVENUE
Division of Taxation
Tax Incentives for Employers
RIGL § 44-55
TAXPAYER NAME
ADDRESS
CITY
STATE
ZIP CODE
SOCIAL SECURITY NUMBER OR FEDERAL EMPLOYER IDENTIFICATION NUMBER
TAX YEAR ENDING
In the section below, list the name and required information for each employee for whom qualifying costs are claimed. The
employee must remain employed by the business for a minimum period of 52 consecutive weeks AND a minimum of 1,820
hours of paid employment BEFORE the employer can claim the credit.
Attach a copy of each employee’s certification of eligibility under this program issued by the Department of Labor & Training.
(a)
(b)
(c)
(d)
(e)
(f)
Employee Name
Social Security
Employee’s
Employee’s First
Multiply Wages
Incentive
Number
Anniversary Date
Year Wages
in (d) times 40%
(Max $2,400)
1.
Total Incentive for all employees. Add together all of the amounts in column (f)...................................................................
Instructions:
(a) Enter the name of each employee for whom wages under this chapter are claimed.
(b) Enter each employee’s complete social security number.
(c) Enter each employee’s anniversary date of hire.
(d) Enter the amount of “First year wages” paid to each employee
(e) For each employee, calculate the incentive per employee by multiplying the costs incurred from column (c) by 40%.
(f) For each employee, enter the lesser of the amount in column (d) or $2,400.00.
1. Add up the credit amount for each employee from column (e) and enter here.
This is your Tax Incentives for Employers. Enter here and on RI-1040 or RI-1040NR, Schedule M, line 2M; RI-1120C,
Schedule B, line 2G; Form RI-1120S, Section B, line 2D; Form RI-1065, Schedule B, line 2D; Form T-71, line 3d, or Form
T-74, Schedule B, line 5.
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