Schedule A (Form Lpc-1) - Allocation Schedule And Calculation Of Fee

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Schedule A
Application for a Land Preservation Credit
*VALPCA110888*
Allocation Schedule and Calculation of Fee
Form LPC-1
•
For an original Land Preservation Tax Credit derived from a donation by joint donors including married taxpayers, provide the information requested
for each person or entity.
•
If you are a pass-through entity (such as an S Corporation), provide the information requested for each person or entity receiving a credit amount. A
separate Schedule A must also be completed for each pass-through entity receiving a credit amount. Attach additional pages, if needed.
•
If the allocation is to more than 15 persons/entities, we recommend submitting a CD or disc. Please call (804) 786-2992 for disc format.
•
For a donation made on or before December 31, 2006, complete Section I (if applicable) and II.
•
For a donation made on or after January 1, 2007, complete Sections I (if applicable), II and III (if applicable).
Section I - Pass-Through Entity Information
For a Pass-Through Entity, Name
FEIN
Phone Number
For a pass-through entity, do you have a tax matters representative?
Representative’s Phone Number
Original Credit Transaction Number (For Office Use Only)
 No
 Yes (If Yes, Enter Name)
LP
Section II - Credit Holder Information
Amount
Credit Holder Information
Name
SSN/FEIN
Street Address
Entity Type
1.
City, State, ZIP
Phone Number
00
Name
SSN/FEIN
Street Address
Entity Type
2.
City, State, ZIP
Phone Number
00
Name
SSN/FEIN
Street Address
Entity Type
3.
City, State, ZIP
Phone Number
00
Name
SSN/FEIN
Street Address
Entity Type
4.
City, State, ZIP
Phone Number
00
Name
SSN/FEIN
Street Address
Entity Type
5.
City, State, ZIP
Phone Number
00
Total Credit Amount Allocated
00
Section III - Calculation of Fee (For donations made on or after January 1, 2007.)
(
)
Not Applicable for Donations
$10,000 00
1. Maximum fee that can be charged on this donation for allocations by the donor(s).
Recorded on or after July 1, 2010
2. Enter the amount of fee that has been previously paid by this donor(s) on this donation.
(
)
Not Applicable for Donations
3. Line 1 minus Line 2. (If the amount is zero or less, stop here. No additional fee is due.)
Recorded on or after July 1, 2010
4. Enter the total credit amount allocated, less any gifts.
5. Multiply the total credit amount allocated by 5% (Line 4 times .05).
6. Fee Due - For donations recorded from January 1, 2007 - June 30, 2010, enter the amount from Line 5 or Line 3,
whichever is less; for donations recorded on or after July 1, 2010, enter the amount for Line 5.
Va. Dept. of Taxation LPC-1 W (Rev 06/10)

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