Schedule A
List of Qualifying Clean-Fuel
*VA305A113888*
Vehicle and Advanced Cellulosic
Form 305
Biofuels Jobs And Employees
Tax Year _______________
Attach to Form 305, Clean-Fuel Vehicle and Advanced Cellulosic Biofuels Job Creation Tax Credit.
If more space is needed, attach additional schedules or a list containing the information below.
Page
of
Name of Company
Virginia Account Number
Federal Employer Identification Number
Complete Columns A through D for each employee, listing all qualifying employees performing jobs that qualify for the credit.
This information will be used when completing Form 305, Lines 4a, 4b and 4c. Complete a separate Schedule A for each
location. See Part I of Form 305 to determine whether a job qualifies as a full-time, clean-fuel vehicle job for purposes of this
credit. Directions for completing Columns A through D follow.
Column A.
Enter the company’s tracking number (position number, job number, etc.) for the qualifying position. If this job
has been held by more than one employee during the period in which the credit is computed for the current
taxable year, attach a statement of explanation which includes the number of the other employee(s) holding
this position.
Column B.
Enter the employee’s name and social security number.
Column C.
Enter the date that qualifying employment began. If the employee leaves the qualifying job, whether through
promotion, transfer or termination, enter the ending date in parenthesis.
Column D.
When completing Column D, enter only the number of full weeks worked by the employee during the taxable
credit year.
If more space is needed, attach additional schedules or a list containing the information below.
PART I Identify Qualifying Employees and Jobs
Column A
Column B
Column C
Column D
Beginning Date of
No. Qualifying Full
Position Number or
Employee's Name and SSN
Qualifying Employment
Weeks Employed
Job Number
(Ending Date)
During Taxable Year
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
PART II Compute the Number of Qualifying Employees
A.
Enter the number of jobs above that qualify for the clean-fuel vehicle job creation tax
credit. Enter here and the applicable amounts on Form 305, Lines 4a, 4b and 4c . . . . . . .
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