Form K-34 - Business And Job Development Credit
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3K-34
KANSAS
BUSINESS AND JOB DEVELOPMENT CREDIT
(Rev. 8/11)
For the taxable year beginning, _________________ , 20____ ; ending _________________ , 20____ .
Name of taxpayer (as shown on return)
Social Security Number or Employer ID Number (EIN)
If partner, shareholder or member, enter name of partnership, S corporation, LLC or LLP
Employer ID Number (EIN)
PART A – DESCRIPTION OF QUALIFIED BUSINESS FACILITY
1. Name of legal entity making investment: ___________________________________
EIN: ____________________________
2. Location of qualified business facility:
a. Street Address ________________________________________________________________________________________
b. City
__________________________________ County No. _______________
County Name ______________________
c. NAICS __________________________________
3. Date operation began at this qualified business facility (mm/dd/yyyy):
___ ___ ___ ___ ___ ___ ___ ___
4. Indicate the type of business activity conducted at this facility (check appropriate box):
ˆ
ˆ
Retail or Service
Nonmanufacturer - Regular
ˆ
ˆ
Manufacturer
Nonmanufacturer - Business Headquarters
ˆ
ˆ
Contractor - Retailer
Nonmanufacturer - Ancillary Support
ˆ
ˆ
Contractor - Nonmanufacturer
Nonmanufacturer -
NAICS 45411_____, 511210_____, 711212_____
(auto racetracks only)
5. Please check the box that best describes the type of qualified investment made at this facility:
ˆ
New facility
ˆ
Investment or expansion at an existing facility
ˆ
Move from old Kansas location to new Kansas location
ˆ
Move from out of state to new location in Kansas
ˆ
Other: ______________________________________________________________________________________________
ˆ
No new investment (for recomputing credits)
6. Date of investment made during the tax year for the qualified business facility (mm/dd/yyyy): ___ ___ ___ ___ ___ ___ ___ ___
7. Attach description of the investment made (see instructions).
PART B – COMPUTATION OF CREDIT
(a)
(b)
Retail or Service
Manufacture / Nonmanufacturer
8a. Number of qualified business facility employees ..........................
______________________________
_____________________________
8b. Total Kansas payroll for employees identified on line 8a ...............
______________________________
_____________________________
9. Qualified business facility employee credit ...................................
______________________________
_____________________________
10. Qualified business facility investment ...........................................
______________________________
_____________________________
11. Qualified business facility credit factor .........................................
______________________________
_____________________________
12. Qualified business facility investment credit .................................
______________________________
_____________________________
13. Total credit or prior year’s carry forward
.......
______________________________
_____________________________
(must complete worksheet )
14. Amount of credit used ...................................................................
_____________________________
15. Carry forward amount
....................................
_____________________________
(must complete worksheet)
Retail or Service
ˆ
16. Qualified business facility income (attach schedule) ....................
______________________________
I would like to defer this
credit to __ __ __ __ .
17. Tax on qualified business facility income
........
______________________________
(must complete worksheet)
18. Business and job credit limitation (50%) ........................................
______________________________
(not to exceed 3 years)
19. Business and job development credit ............................................
______________________________
Shareholder or Partner (attach schedules)
20. Ownership percentage .................................................................
______________________________
_____________________________
21. Shareholder or partner amount of credit .......................................
______________________________
_____________________________
22. Shareholder or partner Kansas tax liability
.....
______________________________
_____________________________
(must complete worksheet)
23. Amount of credit used ...................................................................
______________________________
_____________________________
24. Carry forward amount
....................................
_____________________________
(must complete worksheet)
Payroll Information
A.
Total employment in the state of Kansas .......................................
______________________________
_____________________________
B.
Total payroll in the state of Kansas ...............................................
______________________________
_____________________________
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