Schedule Sc - Septic Credit Credit For Repairing Or Replacing A Failed Cesspool Or Septic System - 2012

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Schedule SC

2012

Septic Credit

Massachusetts

Credit for Repairing or Replacing

Department of

a Failed Cesspool or Septic System

Revenue

Name(s) as shown on Massachusetts Forms 1, 1-NR/PY

Social Security number(s)

Address of principal residence with a failed system (must be in Massachusetts; do not enter PO box)

City/Town

State

Zip

Part 1. General Information

1a Date certificate of compliance or verification letter issued:

. Retain a copy of Certificate of Compliance or verification letter.

____________________________________________________________________

1b Name of approving authority:

____

If you were the sole owner of the property, enter 100%; otherwise enter the percentage of the total actual costs that you paid:

%. Also, list

names, addresses and percentage of ownership of any co-owners of the above property. If a condominium, list legal name of the condominium

______________________________________________________________

association and total number of owners:

If you received a subsidized loan from the Commonwealth, or a betterment issued by a municipality to complete repairs or replacement of a qualified

cesspool or septic system, complete the following (you must also complete Part 5):

Subsidized loan issued under homeowner septic repair program

__________________________

Name of participating lender:

__________

Amount of loan: $

__________

Loan term (in months):

____

Interest rate (must be either 0%, 3% or 5%):

Loan issued by municipality and assessed as a betterment (see instructions) to your property tax bill

__________________________

Name of municipality:

__________

Amount of betterment: $

______

Number of years to repay betterment:

____

Interest rate:

Part 2. Computation of Credit.

Complete Part 2 only if Certificate of Compliance or verification letter was issued in 2012.

4a Briefly describe the nature of expenditures made to comply with Title 5 or to connect to a municipal sewer system pursuant to a federal court order,

Administrative Consent Order, state court order, consent decree or similar mandate. Complete details

must be available upon request. Also include any actual costs incurred in 1995 through 2011.

Date paid

Actual cost

25 Total actual costs to repair or replace a failed cesspool or septic system or to connect to a municipal sewer system.

Add all amounts in line 4, col. c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

26 Maximum amount available for computation of the credit. Enter the smaller of line 5 or $15,000. . . . . . . . . . . . . . . . . . . . . 6

27 Amount of actual costs available for the credit. Multiply line 6 by .40 (40%) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7