Form Ri-6238 - Residential Lead Abatement Credit - 2004
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1RI – 6238
2004
State of Rhode Island – Division of Taxation
RESIDENTIAL LEAD ABATEMENT CREDIT
PERSONAL INCOME TAX ONLY!
PLEASE READ INSTRUCTIONS ON REVERSE BEFORE COMPLETING THIS FORM
ATTACH COPIES OF BOTH CERTIFICATES REFERENCED BELOW.
Complete one form for each dwelling unit claimed.
Name (s)
Social Security #
___________________________________
_______________________
Address
Social Security #
___________________________________
_______________________
City/Town
State
Zip
______________________________________________________________________
Address of the dwelling for which credit is claimed:
Street
City/Town
Zip
Licensed hazard reduction contractor (information on reverse)
Name:___________________________________
Lic.# ___________________
CHECK ONE BOX BELOW
Taxpayer is the/an owner of the dwelling listed above.
Taxpayer is a renter/lessee of the dwelling listed above.
CALCULATION:
1.
Amount paid for required lead
removal or lead hazard reduction
for this dwelling unit.
$ ___________
2.
Credit limit per dwelling unit
$
1,000.00
3.
Credit limit (smaller of line 1 or 2)
$ ___________
4.
Credit claimed by this taxpayer.
(Multiple owners must divide. Refer
to instructions and attach details
of division.)
$ ___________
DOCUMENTATION AND CERTIFICATES REQUIRED: Taxpayers MUST ATTACH
copies of certificates from BOTH (1) the certified environmental lead inspector that the
lead removal or lead hazard reduction was required AND (2) the certified environmental
lead inspector that the dwelling unit has been completed in accordance with all
applicable requirements and that the dwelling is acceptable for re-occupancy.
Taxpayers must retain payment documentation to substantiate the amounts paid for
lead removal/reduction.
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