Form Ste - Application For Sales Tax Exemption - 2013

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2013

Form STE

Massachusetts

Application for

Department of

Sales Tax Exemption

Revenue

For calendar year 2013 or taxable year beginning

and ending

General Information

Motion picture production company name (“Company”)

Federal Identification number

Mailing address

City/Town

State

Zip

Name of production

Expected or actual release or premiere date of this production

Type of production

Feature film

Television series

Documentary

Commercial/advertisement

Other (explain)

Designated production company representative

Telephone

E-mail address

Massachusetts qualifying period start date

Massachusetts qualifying period end date

Name of payroll service provider (if any)

Federal Identification number

Mailing address

City/Town

State

Zip

Estimated Production Information

Everywhere

Massachusetts

Start date

End date

Start date

End date

Pre-production

Production

Post-production

01 Type of entity:

Corporation

Trust

Partnership

Sole proprietorship

LLC

02 Is company or its payroll service provider registered for withholding of Massachusetts personal income tax on salaries paid to its employees?

Yes

No. If No, use our Webfile for Business application to register for withholding and wage reporting once you have employees subject to

Massachusetts withholding.

03 Is company (including the parent or an affiliate of the company) in default on a loan made or guaranteed by the Commonwealth (see TIR 06-01)?

Yes

04 Company’s total estimated qualifying production costs everywhere during the period (see TIR 06-01) . . . . . . . . . . . . . . . . . . . 4

05 Company’s total estimated qualifying production costs in Massachusetts during the period (see TIR 06-01) . . . . . . . . . . . . . . 5

06 Total wages and salaries included in line 5, excluding salaries over $1,000,000. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

07 Wages and salaries of $1,000,000 or over paid to an individual and included in line 5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

08 Cost of set construction and operation included in line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

09 Location fees and cost of rental or purchased facilities and equipment included in line 5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

10 Total other Massachusetts production expenses included in line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

11 Estimate of Massachusetts production expenses included in line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

12 Estimate number of principal photography days of the film . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

13 Estimate number of principal photography days taking place in the Commonwealth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

I declare under the pains and penalties of perjury that to the best of my knowledge, the information contained herein is accurate and complete.

Signature

Date

Mail to: Massachusetts Department of Revenue, Audit Division, 200 Arlington Street, Room 4300, Chelsea, MA 02150, attn.: Film Credit Unit.