Alternative Tax Credit For Oil And Gas Exploration Under As 43.55.025 Page 7

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Alaska
310
Alternative Tax Credit for Oil and Gas
Exploration under AS 43.55.025
Schedule F - Individual Tax Credit Information
THIS FORM SHOULD BE COMPLETED BY EACH PARTNER/JOINT APPLICANT INDIVIDUALLY AND SENT DIRECTLY TO THE TAX DIVISION.
THIS INFORMATION WILL NOT BE DISCLOSED TO THE OTHER PARTNERS/JOINT APPLICANTS AND WILL BE HELD CONFIDENTIAL UNDER
AS 43.05.230 AND 40.25.100.
Federal EIN
Date of Claim
Taxpayer Name
Contact Person
Contact Phone Number
Email Address of Contact Person
Tax Credit Application Information
Project Name
Designated Joint Applicant’s Name
Location of Exploration Well, Seismic, or Other Geophysical Project
Completion Date of Exploration Project
Total Qualifying Expenditures Claimed for Project
Total Credit Claimed for Project
Individual Credit Filing Information
Portion of applicants total expenditures in AS 43.55.025 claim for above project (dollars) ____________________________ *
*This amount should tie to Schedule E of Form 310, filed by designated joint applicant
Calculate total credit request under AS 43.55.025 based on expenditures not already claimed under AS 43.55.023(a) or (I)
Amount of same expenditures for above project claimed under AS 43.55.023(a) or (l) $_____________________
Total expenditures qualifying for current AS 43.55.025 claim $______________________
0.00%
Credit % ______________________
Total credit amount requested $ ______________________
Notes to claim:
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
I declare under penalty of perjury that I am authorized to act on behalf of the filer.
Signature
Date
Printed Name
Printed Title
This form is available online at
310
Submit completed applications via the Tax Division Online Tax
Information System (OTIS) at
0405-310 Rev 09/06/13- page 7

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