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Note. For this purpose, both actual

1504(a)) connected through stock

A controlled group of corporations

ownership with a common parent

(defined in section 52(a)). For the

employees of the applicant and leased

corporation. The common parent must be

definition of a controlled group of

employees may be included.

an includible corporation and the following

corporations, see Eligible Taxpayer,

Lines 26 and 27

requirements must be met.

earlier.

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A group of trades or businesses under

1. The common parent must own

The applicant can attach a statement, not

common control (defined in section

directly stock that represents at least 80%

to exceed 250 words, supporting line 26

52(b)).

of the total voting power and at least 80%

and a statement, not to exceed 250

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An affiliated service group (defined in

of the total value of the stock of at least

words, supporting line 27.

section 414(m)).

one of the other includible corporations.

Attach a statement listing the name,

Part III. Qualified

2. Stock that represents at least 80%

address, and EIN of each of the other

of the total voting power and at least 80%

Investment

members.

of the total value of the stock of each of

the other corporations (except for the

Enter on lines 28 through 33 the amount

For purposes of this section, the term

common parent) must be owned directly

of qualified investment in each listed

employee includes both full-time and

by one or more of the other includible

category. Qualified investments may

part-time employees but does not include

corporations.

include expenses for wages, supplies and

leased employees.

lab costs, depreciable property, contractor

Line 17

For this purpose, the term “stock”

costs, and any other costs that would be

generally does not include any stock that

considered part of the qualified

Complete line 17 to elect to apply for a

(a) is nonvoting, (b) is nonconvertible,

investment for the project. Applicants for

QTDP grant for tax year 2009, 2010, or

QTDP grants for tax year 2009 whose

both. If the applicant elects to apply for a

and does not participate significantly in

2009 tax year ends after the date the

QTDP grant, complete lines 18 and 19.

corporate growth, and (d) has redemption

application is filed must complete column

Otherwise, skip to line 20.

and liquidation rights that do not exceed

(a) and columns (b) and (c), as

the issue price of the stock (except for a

If the applicant is filing multiple

applicable. All other applicants, complete

reasonable redemption or liquidation

applications, the elections made

only columns (b) and (c), as applicable.

premium). See section 1504(a)(4). See

on all of the applications must be

CAUTION

Qualified investments do not include

section 1563(d)(1) for the definition of

consistent. See Consistency requirement,

amounts paid or incurred to another

stock for purposes of determining stock

above.

person for research services relating to

ownership.

the project if the research services were

Line 18

not performed on behalf of the applicant.

Lines 9 through 12

Enter the applicant’s unique nine-digit

If the applicant is filing applications for

Enter the name, address, and EIN of the

Data Universal Numbering System

multiple projects, qualified investment

common parent. See the instructions for

(D-U-N-S) number from Dun and

included for any project on any one Form

Lines 3 and 4 for entering address

Bradstreet. If the applicant does not

8942 cannot include amounts included in

information.

already have a D-U-N-S number, it may

qualified investment for any other project

request one at no cost by calling the

on any other Form 8942. Qualified

Line 13

dedicated toll-free D-U-N-S number

investments related to multiple projects,

request line at 1-866-705-5711.

Enter the name and address of the

must be allocated between the projects

Information on obtaining a D-U-N-S

contact person. See the instructions for

using a reasonable method.

number may be obtained at

Lines 3 and 4 for entering address

Column (a). Enter in column (a) of each

gov/applicants/org_step1.jsp.

information.

line qualified investment that is the sum

of:

The contact person is the person the

Line 19

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Qualified investment actually paid or

IRS or HHS may contact if there is an

Entities referred to in section 54(j)(4) are

incurred as of the date the application is

issue with the application. If the contact

the following.

filed; and

person does not have legal authority to

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Cooperative electric company. This is a

Qualified investment projected to be

bind the applicant, the applicant must

mutual or cooperative electric company

paid or incurred between the date the

attach to Form 8942 a properly executed

described in section 501(c)(12) or

application is filed and the earlier of the

Form 2848. On Form 2848, line 3, enter

1381(a)(2)(C), or a not-for-profit electric

end of the 2009 tax year or September

“Section 9023 of the Affordable Care Act”

utility that has received a loan or loan

30, 2010.

as the type of tax. Leave the entry spaces

guarantee under the Rural Electrification

for Tax Form Number and for Year(s) or

Column (b). Enter the total amount paid

Act.

Period(s) blank. Check the box on line 4.

or incurred (including the amount

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Clean renewable energy bond lender.

projected to be paid or incurred) for the

Line 14

This is a lender that is a cooperative

2009 tax year for each cost on line 28

which is owned by, or has outstanding

through line 33.

On line 14a, enter the name of the

loans to, 100 or more cooperative electric

Column (c). Enter the total amount paid

project. If the applicant is filing

companies and is in existence on

or incurred (including the amount

applications for more than one project,

February 1, 2002, and including any

projected to be paid or incurred) for the

select names for the different projects that

affiliated entity which is controlled by such

2010 tax year for each cost on line 28

are readily distinguishable from each

lender.

through line 33.

other.

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Governmental body. This is any state,

Line 31

On line 14b, enter a brief description of

territory, possession of the United States,

the project. Limit the description to 50

the District of Columbia, Indian tribal

Qualified investment derived from

words or fewer.

government, and any political subdivision

third-party contractors only includes

thereof.

amounts paid or incurred on behalf of the

Lines 15 and 16

applicant pursuant to an agreement that

Line 21

Enter the number of employees in all

is entered into prior to the performance of

businesses of the applicant on the date

Enter the number of full-time and

the research services relating to the

the application is filed. In determining the

part-time employees in the United States

project and the agreement required that

number of employees, include the

whose work is directly billed to the project

the research services be performed on

employees of all members of the following

and the average salaries of the

behalf of the applicant. If research

that the applicant is a member of.

employees in each category.

services are not performed on behalf of

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Instructions for Form 8942 (June 2010)

Instructions For Form 8942 - Application For Certification Of Qualified Investments Eligible For Credits And Grants Under The Qualifying Therapeutic Discovery Project Program Page 4

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