Schedule Rd - Credit For Increasing Research Activities - 2016 Page 2

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RD page 2

16704

Credit for Increasing Research Activities 2016 (continued)

Name of Corporation

FEIN

Minnesota Tax ID

Round amounts to nearest whole dollar.

24 Subtract line 23 from line 7 (if zero or less, enter zero) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25 Enter the amount from line 24 or $2,000,000, whichever is less . . . . . . . . . . . . . . . . . . . . . .

26 Subtract line 25 from line 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

27 Multiply line 25 by 10% (.10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

28 Multiply line 26 by 2.5% (.025) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

29 2016 credit (add lines 27 and 28; see instructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

30 Carryover credit and your share of any credit from partnership (see instructions) . . . . . . .

31 Tentative credit (add lines 29 and 30) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

32 Limitation (see instructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

33 Credit for increasing research activities (enter the amount from line 31 or line 32,

whichever is less). Enter this amount on M4T, line 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Attach this schedule and a copy of federal Form 6765 to your Minnesota return.

Additional Information. Please check the appropriate box.

Yes

1. Did a CPA, attorney, consultant or other:

a. Assist in the calculation or preparation of the tax credit? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b. Conduct a R&D tax credit study? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If “Yes” is checked on lines 1a or 1b, provide the following information for each individual who assisted in the calculation or preparation

of the tax credit or conducted a tax credit study. (If more than one individual, attach a schedule for each with the following information):

Individual’s Name

Individual’s Title

Individual’s Company

Individual’s Phone Number

c. If “Yes” is checked on lines 1a or 1b, may the Minnesota Department of Revenue discuss the tax credit with the

individual(s) who assisted in the calculation or preparation of the tax credit or conducted a tax credit study? . . .

Review of

Combination of review of

contemporaneous

Estimation

contemporaneous

records

records and estimation

2. How were the following calculated: check appropriate box.

a. Wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b. Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c. Contracted Research . . . . . . . . . . . . . . . . . . . . . . . . . .

3. Were the following performed/conducted within the state of Minnesota:

a. Wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b. Contracted Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If “No” is checked on lines 3a or 3b, the taxpayer cannot claim those expenses in calculating the tax credit.

4. Was the claimed research performed at the request of another individual or entity? . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5. Was the claimed research performed as part of a joint venture with another individual or entity? . . . . . . . . . . . . . . . . .

9995