Form RPD-41281 Job Mentorship Tax Credit Claim Form

(a) Tax year of previously allowed credit (b) Credit allowed in previous tax year (c) Total credit claimed in previous tax years (d) Unused credit for available for carry forward [(b) (c)] (a) Tax year of previously allowed credit Enter the tax year for each credit allowed in a previous tax year Do not include any credit allowed for a tax year more than three years prior to the current tax year Enter the tax year if the credit was al lowed for a full calendar year For fiscal year and short year returns enter the beginning and ending dates of the tax year For example enter 2003 if the tax year is a calendar year or enter July 1 2002 to June 30 2003 if the tax year is a fiscal (d) Unused credit available for carry forward from prior years Subtract column (c) from column (b) Enter the sum of all amounts in column (d) on line 5 of the current year claim form RPD 41281 7 Enter the portion of total credit available (from line 6) claimed on your current New Mexico income tax return The aggregate credit claimed by a business in any tax year cannot be greater than $12 000 If the credit is to be claimed by two or more owners partners or associates complete the Division of Total Available Credit Report in Schedule A Each owner partner or associate enters on this line only the amount claimed on the individual Attach Schedule A to RPD 41281 Job Mentorship Tax Credit Claim Form if you have unused Job Mentorship Tax credit available for carry forward from prior years or your total available credit can be claimed by one or more owners partners or associates business owners partners or associates eligible to claim a portion of the total Job Mentorship Tax Credit available to be Calculate the total unused credit available for carry forward from prior years from the worksheet on Schedule A and enter here Include a copy of Schedule A with this claim form claim a Job Mentorship Tax Credit for each taxable year in which the business employs one or more qualified students (*See Important Definitions in the instructions) To claim the credit the taxpayer must submit this form and all required attachments with the eligible employer s personal or corporate income tax return Form RPD 41280 Job Mentorship Tax Credit Certificate claimed in the current tax year Enter the federal employer identification number (FEIN) or the social security number (SSN) used to file each owner s partner s or associate s New Mexico income tax return Enter the percentage which represents complete the following information for each eligible owner partner or associate below Enter the name and address of all Credit allowed in the previous tax year For each credit allowed in a previous tax year listed in column (a) enter the total amount of credit allowed for the business as indicated on line 4 of the Form RPD 41281 filed for that year Division of the Total Available Credit Report Enter the beginning and ending dates of the tax year of this claim: From to Enter the gross wages paid during the current tax year to the qualified students included in line 2 The maximum gross wages for each qualified student cannot exceed gross wages paid for more than 320 hours of employment during a tax year Enter the number of qualified students employed during the tax year: The credit cannot be allowed for more than 10 qualified students in the current tax year and you cannot include a qualified student for more than 3 tax years Attach Form RPD 41280 Job Mentorship Tax Credit Certificate for each qualified student Enter the sum of lines 4 and 5 This is the total credit available in the current tax year for the qualified New Mexico business form and required attachments to your return will result in denial of the credit I certify that: (You must check the box ) If the Job Mentorship Tax Credit for the New Mexico business is divided among two or more owners partners or associates Job Mentorship Tax Credit Claim Form Mailing Address City State and ZIP Code Multiply line 3 by 50% (0 50) This is the maximum credit allowed in the current tax must be attached for each qualified student employed and included in this claim See the instructions Name and address of owner partner or associate FEIN or SSN Percentage of interest Name and address of owner partner or associate FEIN or SSN Percentage of interest Name and address of owner partner or associate FEIN or SSN Percentage of interest Name of Contact Phone Number Fax Number and E mail Address Name of Qualified New Mexico Business (Employer) New Mexico CRS Identification No Purpose of Form Form RPD 41281 Job Mentorship Tax Credit Claim Form is used by a taxpayer who is not a dependent of another taxpayer and who is an owner partner or associate of a New Mexico business* that employs qualified students* in a career preparation education program* sponsored by an accredited New Mexico secondary school The taxpayer may return Include a copy of Schedule A with each claim form filed Enter the credit claimed on the applicable line of the New Mexico income tax form PIT 1 CIT 1 or S Corp The Job Men torship Tax Credit may only be deducted from the taxpayer s New Mexico income tax liability NOTE: Failure to attach this Schedule A Signature of claimant Date State of New Mexico Taxation & Revenue Department State of New Mexico Taxation and Revenue Department Street Address City State and ZIP Code the hiring of the qualified student(s) included in this claim does not displace or replace a current employee the owner s partner s or associate s interest in the partnership limited partnership limited liability company S corporation or other business association If additional space is needed attach a separate schedule total amount of credit claimed by all owners partners or associates eligible to claim the Job Mentorship Tax Credit available Include credit claimed in all previous tax years For each tax year current year credits are applied before applying carry forward credits Total credit claimed in previous tax years For each credit allowed in a previous tax year listed in column (a) enter the Under penalty of perjury I declare that I have examined this claim and to the best of my knowledge and belief it is true correct and complete Worksheet to calculate the total unused credit available for carry forward from prior years