Instructions For Schedule Em-C - Wisconsin Department Of Revenue

Example: An applicant has a fiscal year beginning

2012 Calendar Year Certification

October 1, 2012 and ending on September 30,

2013. The applicant will file a certification request on

$20,000

a 2012 Schedule EM-C for the period of October 1,

$20,000 X $10,000 = $10,000

2012 through December 31, 2012 by January 31,

2013.

2013 Calendar Year Certification

By January 31, 2014, the applicant will file a 2013

Schedule EM-C for the amounts paid for information

Computation for 2012 fiscal year:

technology hardware and software from January 1,

2013 through December 31, 2013.

$17,000

$30,000

X $12,000 = $6,800

The applicant is awarded electronic medical record

credits of $10,000 and $12,000 for the calendar

The amount of $16,800 ($10,000 + $6,800) is

years 2012 and 2013 respectively. The applicant

entered on line 1 of the 2012 Schedule EM.

paid the following amounts for certified information

technology software and hardware:

$8,000+$5,000+$4,000

$8,000+$5,000+$4,000+$3,000+$10,000

Computation for 2013 fiscal year:

Date

Amount

$13,000

11/02/12

$20,000

$30,000

X $12,000 = $5,200

2/04/13

$ 8,000

8/01/13

$ 5,000

Enter this amount on line 1 of the 2013 Schedule

9/27/13

$ 4,000

EM.

10/22/13

$ 3,000

12/16/13

$10,000

$3,000+$10,000

$8,000+$5,000+$4,000+$3,000+$10,000

The department will notify the applicant by February

28, 2013 of the credit that may be claimed based on

the expenses paid in the 2012 calendar year. In this

Additional

Information

example the applicant may claim an electronic

medical records credit of $10,000.

For more information, you may:

For expenses paid in the 2013 calendar year, the

• Access common questions of the electronic

department will notify the applicant of the allowable

medical records credit at:

credit by February 28, 2014. In this example,

revenue.wi.gov/faqs/ise/elecmedrec.html

applicant is eligible for a credit of up to $15,000;

however, the department has allocated a credit of

• E-mail your question to

corp@revenue.wi.gov

$12,000. Because the applicant has a fiscal taxable

year that begins in 2012 and ends in 2013, an

• Call (608) 266-2772 [TTY: Call the Wisconsin

allocation is required in order to determine the

Telecommunications Relay System at 711, if no

amount of credit that may be claimed in the 2012

answer, dial 1-800-947-3529]

and 2013 taxable years. The credit for the 2013

calendar year must be allocated to the applicants

• Send a FAX to (608) 267-0834

fiscal year based on a ratio consisting of the

amounts paid during the calendar year that falls

• Write to the Audit Bureau, Wisconsin Department

within the dates of the taxpayers fiscal year divided

of Revenue, Mail Stop 5-144, PO Box 8906,

by the total amounts paid in the 2013 calendar year,

Madison, WI 53708-8906.

with the result multiplied by the applicant's credit

awarded for the 2013 calendar year.

Instructions For Schedule Em-C - Wisconsin Department Of Revenue - 2012 Page 3

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