Schedule B3 Corporation

EMPLOYEE RETENTION CREDIT

20__

Rev. 03.12

(Hire Incentives to Restore Employment Act)

Taxable year beginning on _______________, _____ and ending on _______________ de _____

Taxpayer's name

Employer Identification Number

Part I

Detail of Credit per Employee

(A)

(B)

(C)

(D)

(E)

Retained Worker

No. 5

No. 1

No. 2

No. 3

No. 4

1. Employee's social security number .....................................................

(01)

____/____/ 2010

Employee’s first day of employment ……………………….……............…

(02)

Day Month

3. Total wages for the first 26 consecutive weeks of employment .................

(03)

4. Multiply line 3 by 80% ......................................................................

(04)

5. Total wages for the second 26 consecutive weeks of employment. If line 4 is

larger than this line, do not continue. The employee is not a retained worker

and is not eligible for the credit ……......................................……………

(05)

6. Add lines 3 and 5 .............................................................................

(06)

7. Multiply line 6 by 6.2% ....................................................................

(07)

1,000

8. Maximum credit ...............................................................................

(08)

9. Enter the smaller of lines 7 or 8 ...........................................................

(09)

10. Add line 9 of Columns A through E ..........................................................................................................................................................................................................................

(10)

Part II

Total Credit for Retained Workers

1.Enter line 10 of all Schedules B3 Individual included

......................................................................................................................................................................................................

(01)

2. Enter the total number of employees for whom you are claiming a credit on line 1 .....................................................................................................................

(02)

3. Employee retention credit from flow-through entities (See instructions. Submit the corresponding Informative Returns) ............................................................................................................

(03)

4. Total employee retention credit (Add lines 1 and 3. Transfer to Schedule B Corporation, Part II, line 21) ……………………….....................................................................................................

(4)

Retention Period: Ten (10) years

Schedule B3 Corporation - Employee Retention Credit - 2012

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