Form 304
Major Business Facility
*VA0304115888*
Taxable Year
Job Tax Credit
A separate Form 304 must be completed for each major business facility or qualified job expansion.
Fiscal Year Filers: Begin Date
, and End Date
Name of Company
FEIN or Social Security Number
Street Address
City, State and ZIP Code
Entity Type: (Check One)
C Corporation
S Corporation
Partnership
LLC
Other
Have you applied for any other credit(s) this year? If yes, indicate which credits.
If you applied for a Green Jobs Creation Tax Credit, International Trade Facility Tax Credit or Coalfield Employment Enhancement Tax Credit for the same
.
jobs - STOP, you do not qualify for the Major Business Facility Job Tax Credit
1a.Enter the North American Industry Classification System (NAICS) Code for the Company’s Primary Business in Virginia
1b. Enter the Industry Description
Check here if two or more affiliated companies have aggregated the number of jobs that were created for purposes of qualifying for this credit,
2a.
and attach a separate schedule showing the name of each affiliated company, the Virginia Account Numbers, the Federal Employer Identification
Numbers, the NAICS codes, and the voting percentages (as defined in Va. Code § 58.1-439(S)).
2b. Qualifying Threshold
Economically Distressed Area/Enterprise Zone
Tier 1
Tier 2
100 (for expansions prior to January 1, 2010)
50 (for expansions prior to January 1, 2010)
Tier 1
Tier 2
50 (for expansions on or after January 1, 2010)
25 (for expansions on or after January 1, 2010)
2c. This Major Business Facility is Located in the City / County of
, Virginia.
Date Facility Established or Expanded
This is a new facility.
This is an expanded facility.
Number of Qualifying Employees Prior to First Expansion
(See instructions)
2d. Date Range from Which the Credit is Based (minimum 24 months, maximum 35 months)
.
Expansion Period (12 months) ________________________ Credit Year ________________________
Filing Sequence
Credit Year
Year 2
Year 3
Year 4
Year 5
Year 6
You must include Schedule A and the Schedule A Worksheet for all filing years.
2e. Have you had an expansion before?
Yes or
No. If yes, what year ____________ and number on Line 3a for that expansion ________?
3. Number of Qualifying Employees (See instructions):
If completing this form for the credit year (the first taxable year following the taxable year in which the major business facility was established or
expanded), complete Schedules A and B, then enter the total on Line 3a.
For each of the 5 taxable years after the credit year, enter on Line 3a the number of qualifying employees for the credit year (this should be a constant
number). For Line 3b, enter the overall number of qualifying employees, based on your quarterly filings with the Virginia Employment Commission
for the current year. See the instructions for guidance on computing the amount on Line 3b. (If the number of qualifying employees in any of these
5 years is less than in the initial credit year, a credit recapture may be required on Line 8. See the instructions for Line 8 for additional information.)
3a. Number of Qualifying Employees in the Credit Year
3a.
3b. Overall Number of Qualifying Employees in the Current Year for This Expansion
3b.
See Schedule A and Schedule A Worksheet.
3c.
If Line 3b is Less than Line 3a, Attach a Schedule Showing the Computation for Recapture
3c.
4. Threshold Amount - Enter the Amount from 2b
4.
5. Number of Credit Year Qualifying Employees - Subtract Line 4 from Line 3a
5.
6. Total Credit Allowed for this Major Business Facility or Expansion - Multiply Line 5 by $1,000
6.
7. Current Year Credit - Multiply Line 6 by
1/2 if Your Credit Year's Taxable Year Begins on or After
7.
January 1, 2009 but Before January 1, 2020 OR
1/3 for All Others
8. Credit to Be Recaptured This Year (if applicable)
8.
9. Adjusted Credit - Subtract Line 8 from Line 7 (if applicable)
9.
Declaration: I, the undersigned officer or other person authorized to act on behalf of the business entity, have read and understand the limitations and
restrictions set forth for this application and the associated tax credit.
Authorized Signature
Printed Name
Title
Date
Preparer Name
Preparer Email
Preparer Phone Number
Va. Dept. of Taxation 2601149 304 W
Rev 06/15