Form MO-TC Miscellaneous Income Tax Credits

If you are filing an individual income tax return and you have only one Benefit Number: Include a copy of your certificate/form from the issuing agency * Must be approved by the issuing agency 8609 (first year) HCC Health Care Access (573) 751 6219 Certificate * SCT Shared Care (573) 751 4842 Must Register Each AFI Alternative Fuel Infrastructure (573) 751 2254 Certificate* CPC Charcoal Producers (573) 751 4817 Certificate* WEC Processed Wood Energy (573) 526 1723 Certificate*P O BOX 567 JEFFERSON CITY MO 65102 0567 AHC Affordable Housing Assistance (816) 759 6662 Certificate* Alpha Attach to Alpha Attach to Alpha Attach to Code Name of Credit and Phone Number Form MO TC APU Agricultural Product Utilization Contributor Certificate* Preservation Act (573) 522 8004 Certificate* ATC Special Needs Adoption Form ATC BEC Bond Enhancement (573) 522 9062 Certificate* BFC New or Expanded Business Facility (573) 522 2790 Schedule 150 Fed K 1 BFT Bank Franchise Tax Form INT 2 INT 2 1 Form 4354 BTC Bank Tax Credit for S Corporation Form BTC and Form BJI Brownfield Jobs and Investment (573) 522 8004 Certificate* Shareholders INT 3 2823 INT 2 CBC Community Bank Investment (573) 522 8004 Certificate*Fed K 1 DAL Distressed Area Land Assemblage (573) 522 8004 Certificate* CIC Children In Crisis Contribution Verification DFH Dry Fire Hydrant (573) 751 4539 Certificate* from IssuingAgency DPC Development Tax Credit (573) 526 3285 Certificate* DAC Disabled Access Federal Form 8826 andDTC Demolition (573) 522 8004 Certificate* Form MO 8826EZC Enterprise Zone (573) 751 4539 Schedule 250 Fed K 1 DAT Residential Dwelling Accessibility Form MO DAT Form 4354 FPT Food Pantry Tax Form MO FPT FDA Family Development Account (573) 526 5417 Certificate* SHC Self Employed Health Insurance Form MO SHCFPC Film Production (573) 751 9048 Certificate* SSC Public Safety Officer Surviving Spouse Form MO SSC HPC Historic Preservation (573) 522 8004 Certificate* ISB Small Business Investment (Capital) (573) 522 2790 Certificate* MQJ Missouri Quality Jobs (573) 751 4539 Certificate* NAC Neighborhood Assistance (573) 751 4539 Certificate* NEC New Enterprise Creation (573) 522 2790 Certificate* BUC Missouri Business Use Incentives for Large Certificate* http://www dss mo gov/dfas/taxcredit/index htm (573) 751 7533 Code Name of Credit and Phone Number Form MO TC Code Name of Credit Form MO TC Code Name of Credit Form MO TC JEFFERSON CITY MO 65109 DRC Development Reserve Certificate* Code Name of Credit Form MO TC DVC Shelter for Victims of Domestic Violence Certificate* EFC Export Finance Certificate* Fed K 1 8609A FFC Family Farms Act Certificate* REC Qualified Research Expense (573) 526 0124 Certificate* NGC New Generation Cooperative Incentive Certificate* filing a corporation franchise tax return use Column 2 For Privacy Notice see the instructions MO TC (12 2011) http://www ded mo gov http://dor mo gov/ (573) 526 8733 or (573) 751 4541 http://www dhss mo gov http://www dnr mo gov http://www mdfb org (573) 751 8479 http://www mhdc com I declare under penalties of perjury that I employ no illegal or unauthorized aliens as defined under federal law and that I am not eligible for any tax exemption credit or abatement if I employ such aliens I also declare that if I am a business entity I participate in a federal work authorization program with respect to the employees working in connection with any contracted services and I do not knowingly employ any person who is an unauthorized alien in connection with any contracted services IDC Infrastructure Development Certificate* If you are filing a combined return and both you and your spouse have Alpha Code: income use Column 1 for yourself and Column 2 for your spouse This is the three character code located on the back of the form Each credit If you are filing a corporation income tax return use Column 1 If you are If you are filing a fiduciary return use Column 1 is assigned an alpha code to ensure proper processing of the credit claimed income use Column 1 The number is located on your Certificate of Eligibility Schedule (Certificate) Individuals with speech/hearing impairments may call TDD (800) 735 2966 or fax (573) 526 1881 MO TC (12 2011) Instructions JEFFERSON CITY MO 65105 LHC Missouri Low Income Housing (816) 759 6668 Eligibility Statement MHC Maternity Home Certificate* PRC Pregnancy Resource Certificate* RTA Residential Treatment Agency Certificate* 3435 BROADWAY KANSAS CITY MO 64111 Miscellaneous tax credits are administered by various agencies For more information forms and approval to claim these credits contact the following Departments Visit http://dor mo gov/taxcredit/ for a description of each credit and more contact information for agencies administering each credit NEZ New Enhanced Enterprise Zone (573) 751 4539 Certificate* http://www mda mo gov (573) 751 2129 NMC New Market Tax Credit (573) 522 8004 Certificate* Alpha Attach to P O BOX 118 JEFFERSON CITY MO 65102 0118 P O BOX 2200 JEFFERSON CITY MO 65105 2200 P O BOX 570 JEFFERSON CITY MO 65102 0570 P O BOX 630 JEFFERSON CITY MO 65102 0630 QBC Qualified Beef Certificate* RCC Rebuilding Communities (573) 526 3285 Certificate* Code Name of Credit Form MO TC RCN Rebuilding Communities and Neighborhood RTC Remediation (573) 522 8004 Certificate* SBG Small Business Guaranty Fees (573) 751 9048 Certificate* SBI Small Business Incubator (573) 526 6708 Certificate* Scale Development (BUILD) Alpha Attach to SCC Missouri Business Modernization and TDC Transportation Development (573) 522 2629 Certificate* Technology (Seed Capital) (573) 522 2790 Original Certificate* WGC Wine and Grape Production (573) 751 9048 Certificate* Alpha Attach to Year With Division of Senior and Disability Services Attach Form MO SCC YOC Youth Opportunities (573) 526 5417 Certificate* Code Name of Credit and Phone Number Form MO TC