Form 526-A Draft - Rural Small Business Capital Company Report For Investors - 2011
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3Barcode Placement
State of Oklahoma
Rural Small Business Capital Company
526-A
2
0
Report for Investors
1
The Rural Small Business Capital Company must file Form 526 before this credit will be allowed.
1
A copy of this form must be enclosed with the investor’s income tax return if the credit is claimed.
This form must be furnished to the investor by January 31st. See instructions for further information.
Social Security Number or
Federal Employer
Federal Employer
Identification Number ____________________________
Identification Number ______________________________
Name of Rural Small Business Capital Company:
Name of Investor _________________________________
______________________________________________
Address _________________________________________
Address _______________________________________
City _______________________ State _____ Zip _______
City ____________________ State _____ Zip ________
Telephone Number ______________________________
See Tax Credit Moratorium on page 2.
Part 1:
Establishing the Rural Small Business Capital Credit for
Investors Filing on a Fiscal Year Basis
(4)
(1)
(2)
(3)
Date
Total Investment in,
Credit Allowable
of
or in conjunction with, the Rural
Total Credit Available
in 2011 for investments
Investment
Small Business Capital Company
(Column 2 x 30%)
made on or after 1/1/12
Total Credit Allowable in 2011
Carry the credit claimed this year to Form 511CR. If the entire credit is not being claimed this year, complete Part 2 for the subsequent carryover years.
Under penalties of perjury, I declare I have examined this return, including accompanying statements, and to the best of my knowledge and belief
it is true, accurate and complete.
Officer, General Partner or Member of the Rural Small Business Capital Company: ______________________________________ Date: ___________
Part 2:
2011 Credit Carryover
1.
Total credit allowable in 2011 . ............................................................................... 1.
2.
Credits used in prior years:
Draft
Year
Amount
9/17/11
2011
(a)
$
(b)
2012
$
(c)
2013
$
Total credits used prior to this year . ......................................................... 2.
3.
Unused credit available (line 1 less line 2) ........................................................... 3.
4.
Credit claimed this year, _____ (carry to Form 511CR) ...................................... 4.
5.
Unused balance carryover (line 3 less line 4) (three year carryover limit) . ........... 5.
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