Form Pit-6 - New Mexico Job Mentorship Tax Credit - 2001

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PIT-6
NEW MEXICO JOB MENTORSHIP TAX CREDIT
Tax Year _________
REV. 12/2001
Name
Social Security Number
Business Name
CRS Identification Number
Business Address
City/ State/ Zip
CUMULATIVE TOTAL OF CREDIT CLAIMED FOR THIS TAX YEAR
School to Work
Gross Wages
Credit
Name of Student
Certificate Number
up to 320 Hours
(50% of Gross Wages)
(4)
(1)
(2)
(3)
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
$
$
12,000.00
$
%
$
$
$

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