Form F-1156z - Florida Enterprise Zone Jobs Credit Certificate Of Eligibility For Corporate Income Tax
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4F-1156Z
Florida Enterprise Zone Jobs Credit
R. 01/10
Certificate of Eligibility for Corporate Income Tax
Rule 12C-1.051
Florida Administrative Code
Effective 06/10
Attach this form to the Florida Corporate Income/Franchise and Emergency Excise Tax Return (Form F-1120).
M M
Y Y
M M
Y Y
For calendar year
or other taxable year beginning
/
and ending
/
Name (as shown on your tax return)
Federal Employer Identification Number (FEIN)
Business location address
Enterprise zone number
City
State
ZIP
Area code and telephone number
—
—
Mailing address of business
Check here if business is a "small business" as defined by
section 288.703(1), Florida Statutes. See Instructions for
City
State
ZIP
definition.
PART I
DEmonsTRATIon oF nEw Jobs CREATED
(1)
Enter the number of permanent, full-time jobs on the date of application.
(1)
(2)
Enter the number of permanent, full-time jobs on the date 12 months prior to the date of application.
(2)
(3)
Subtract Line 2 from Line 1. If Line 3 is zero or less, stop here. The business is not eligible for this enterprise
(3)
zone jobs credit.
Social security numbers (SSNs) are used by the Florida Department of Revenue as unique identifiers for the administration of Florida’s taxes. SSNs
obtained for tax administration purposes are confidential under sections 213.053 and 119.071, Florida Statutes, and not subject to disclosure as public
records. Collection of your SSN is authorized under state and federal law. Visit our Internet site at and select “Privacy
Notice” for more information regarding the state and federal law governing the collection, use, or release of SSNs, including authorized exceptions.
schedules A through F. Complete the schedule(s) that apply to your business. Attach the relevant schedules in the
formats shown below. See instructions for explanations of schedules and qualifications for credits.
schedule A - 20% Credit
business in Enterprise Zone
D
A
b
C
G
H
I
J
Date Employed
Total
✓ Check
Enterprise Zone
Actual
Employee name, street Address, City, and ZIP
SSN
Total wages
Credit Amount
E
F
Months
number
if leased
monthly wages
(Col. G X Col. H)
(20% X Col. I)
Began
Ended
employee
Total Credit Amount
schedule b - 30% Credit
business in Enterprise Zone
C
D
G
H
A
b
I
J
Date Employed
Enterprise Zone
Total
Employee name, street Address, City, and ZIP
SSN
✓ Check
Actual
Total wages
Credit Amount
E
F
Months
number
monthly wages
if leased
(Col. G X Col. H)
(30% X Col. I)
Began
Ended
employee
Total Credit Amount
schedule C - 30% Credit
business in Rural Enterprise Zone
A
b
C
D
G
H
I
J
Date Employed
Rural County
Total
Employee name, street Address, City, and ZIP
SSN
✓ Check
Actual
Total wages
Credit Amount
E
F
Months
if leased
name
monthly wages
(Col. G X Col. H)
(30% X Col. I)
Began
Ended
employee
Total Credit Amount
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