RV-F1402401 (12/22)
 Taxable Year                    Taxpayer Name                                                                                                    Account No./FEIN

 Schedule X - Franchise and Excise Tax Job Credit Computation
 Part 1 - Standard Job Tax Credit 
  1.  New Tennessee  jobs created and filled during the current fiscal year .............................(1)   ___________________________  
  2.  Job Tax Credit from jobs created (multiply Line 1 by $4,500)  .............................................(2)   ___________________________  
  3.  New Tennessee jobs created and filled during the current fiscal year by a taxpayer 
   that qualifies for the higher level of investment and job creation credit under the 
   provisions of Tenn. Code Ann. § 67-4-2109(b)(3)(A) ..............................................................(3)   ___________________________
  4.  Job Tax Credit from jobs created (multiply Line 3 by $5,000) ..............................................(4)                               ___________________________
  5.  Job Tax Credit carryover from prior years ..............................................................................(5)                  ___________________________
  6.  Total standard Job Tax Credit available (add Lines 2, 4, and 5)  ..........................................(6)                               ___________________________
  7.  Total franchise and excise taxes (add Schedule A, Line 3 and Schedule B, Line 5) ...........(7)                                              ___________________________
                                                                                                                                                                  %
  8.  Limitation percentage (50% for periods ending on or after July 1, 2009) ..........................(8)   ___________________________
  9.  Multiply Line 7 by Line 8 ...........................................................................................................(9)     ___________________________
 10.  Total before Part 5 limitation (enter the smaller value of Lines 6 or 9 here, and on 
   Part 5, Line 40) ........................................................................................................................ (10)  ___________________________

 Part 2 - Additional Annual Credit
 11.  Jobs qualifying for additional annual credit in Tier 2, Tier 3, and Tier 4 Enhancement
   Counties ................................................................................................................................... (11)   ___________________________
 12.  Additional Annual Credit - Enhancement Counties (multiply Line 11 by $4,500) ........... (12)   ___________________________ 
 13.  Jobs qualifying for additional credit based on a higher level of investment and job
   creation  ................................................................................................................................... (13)   ___________________________ 
 14.  Additional Annual Credit - Higher Investment Level (multiply Line 13 by $5,000)  ........ (14)                                               ___________________________ 
 15.  Jobs qualifying for additional credit based on an Adventure Tourism Zone .................. (15)                                             ___________________________ 
 16.  Additional Annual Credit - Adventure Tourism Zone (multiply Line 15 by $4,500)  ....... (16)                                                 ___________________________ 
 17.  Total Additional Annual Credit (add Lines 12, 14, and 16; enter here and on
   Part 5, Line 37) ........................................................................................................................ (17)  ___________________________

 Part 3 - Job Tax Credit for Hiring Persons with Disabilities
 18.  New full-time Tennessee jobs created and filled during the current fiscal year by
   qualified persons with disabilities ........................................................................................ (18)   ___________________________
 19.  Job Tax Credit from jobs created (multiply Line 18 by $5,000) ......................................... (19)                                 ___________________________
 20.  New part-time Tennessee jobs created and filled during the current fiscal year by 
   qualified persons with disabilities ........................................................................................ (20)               ___________________________
 21.  Job Tax Credit from jobs created (multiply Line 20 by $2,000) ......................................... (21)   ___________________________
 22.  Job Tax Credit for hiring persons with disabilities carryover from prior years ............... (22)   ___________________________
 23.  Total Job Tax Credit for hiring persons with disabilities  available (add Lines 19, 21, 
   and 22)  .................................................................................................................................... (23)   ___________________________
 24.  Total franchise and excise taxes (add Schedule A, Line 3 and Schedule B, Line 5) ........ (24)                                               ___________________________
 25.  Limitation (50% of Line 24) .................................................................................................... (25)        ___________________________
 26.  Total before Part 5 limitation (enter the smaller value of Lines 23 or 25 here, and on 
   Part 5, Line 41) ........................................................................................................................ (26)  ___________________________

 Taxable Year        Taxpayer Name                                                                                                       Account No./FEIN

 Part 4 - Community Resurgence Job Tax Credit
 27.  New Tennessee jobs created and filled during the current fiscal year in
   high-poverty area  .................................................................................................................. (27)  ___________________________
 28.  Job Tax Credit from jobs created (multiply Line 27 by $2,500) ......................................... (28)   ___________________________
 29.  Community Resurgence Job Tax Credit carryover from prior years ................................ (29)                                     ___________________________
 30.  Total Community Resurgence Job Tax Credit available (add Lines 28 and 29)   ............. (30)                                           ___________________________
 31.  Total franchise and excise taxes (add Schedule A, Line 3 and Schedule B, Line 5) ........ (31)   ___________________________
 32.  Limitation (50% of Line 31) .................................................................................................... (32)   ___________________________
 33.  Total before Part 5 limitation (enter the smaller value of Lines 30 or 32 here, and on  
   Part 5, Line 42) ........................................................................................................................ (33)   ___________________________

 Part 5 - Calculation of Overall Limitation
 34.  Total franchise and excise taxes (add Schedule A, Line 3 and Schedule B, Line 5) ........ (34)                                           ___________________________
 35.  Credits from Schedule D, Line 1  .......................................................................................... (35)         ___________________________
 36.  Net tax after Gross Premiums Tax Credits (subtract Line 35 from 
   Line 34; if negative, enter zero) ............................................................................................ (36)         ___________________________
 37.  Additional Annual Credit (from Part 2, Line 17) .................................................................. (37)                  ___________________________
 38.  Total Additional Annual Credit allowable in current year (enter the smaller value of Line 
   36 or 37 here, and on FAE170, Schedule D, Line 7 or FAE174, Schedule D, Line 7)  ...... (38)   ___________________________
 39.  Tax liability after Gross Premiums and Additional Annual
   Credits (subtract Line 38 from Line 36)  .............................................................................. (39)                ___________________________
 40.  Standard Job Tax Credit (Part 1, Line 10) ............................................................................. (40)             ___________________________
 41.  Job Tax Credit for hiring persons with disabilities (Part 3, Line 26) .................................. (41)                            ___________________________
 42.  Community Resurgence Job Tax Credit (Part 4, Line 33) ................................................... (42)                           ___________________________
 43.  Total job credits with carryover provision (add Lines 40 through 42) ............................. (43)                                  ___________________________
 44.  Credits from FAE170, Schedule D, Lines 2,3,4, and 5 
   or FAE174, Schedule D, Lines 2,3,4, and 5  .......................................................................... (44)                  ___________________________
 45.  Net tax after other credits (subtract Line 44 from Line 39; if negative, enter zero) ....... (45)                                        ___________________________
 46.  Total job tax credits allowable in current year excluding Additional Annual Credit
   claimed on Line 38 above (enter the smaller value of Line 43 or 45 here, and on 
   FAE170, Schedule D, Line 6 or FAE174 Schedule D, Line 6) ............................................... (46)                               ___________________________

 Part 6 - Supplemental Information
  a.  Business plan control number.................................................................................................(a)   ___________________________
  b.  Total full-time Tennessee jobs at the beginning of the tax year ........................................ (b)   ___________________________  
  c.  Total full-time Tennessee jobs at the end of the tax year ....................................................(c)   ___________________________

Taxable Year             Taxpayer Name                               Account No./FEIN

Job Tax Credit Carryover

Check applicable carryover type:
If more than one type applies, attach additional pages.  Unused Additional Annual Credit cannot be carried forward.

  Standard Job Tax Credit
  Job Tax Credit for hiring persons with disabilities
  Community Resurgence Job Tax Credit

             Period             Original                                                                                                  Job Tax Credit
             Ended       Return or                   Used in                                                                              Carryover
  Year       MM/YY       as Amended      Prior Year(s)       Expired                                                                      Available
 1
 2
 3
 4
 5
 6
 7
 8
 9
 10
 11
 12
 13
 14
 15

 Amount to carry to Schedule X ...........................................................................................................

Schedule X - Franchise and Excise Tax Job Credit Computation
Instructions:

General Information
     · Prior approval is required for this credit.  In order to receive approval, the taxpayer must file a Job Tax Credit Business 
       Plan or a Job Tax Credit for Hiring Persons with Disabilities Business Plan.  Provided all requirements are met, the 
       taxpayer will be issued a control number.  
General Requirements - Standard Job Tax Credit
 ·     In order to qualify for the standard Job Tax Credit the taxpayer must be a Qualified Business Enterprise as defined 
       in Tenn. Code Ann. Section 67-4-2109(a)(5).  Generally, in order to be a Qualified Business Enterprise the taxpayer 
       must be engaged in manufacturing, warehousing and distribution, processing tangible personal property, research 
       and development, computer services, call centers, headquarters facilities, as defined in Tenn. Code Ann. Section 
       67-6-224(b), back office operations, convention or trade show facilities, or a tourism related business.  
 ·     In order to qualify for the standard Job Tax Credit a capital investment of at least $500,000 must be made within 
       the Investment Period.   
 ·     In order to qualify for the standard Job Tax Credit a minimum number of net new full-time Tennessee jobs must 
       be created and filled within the Investment Period.  The minimum job requirement in a Tier 1 or Tier 2 county is 25 
       net new jobs.  The minimum job requirement is 20 net new Jobs in a Tier 3 county and 10 in a Tier 4 county.
General Requirements - Additional Annual Credit
 ·     In order to qualify for any of the three Additional Annual Credits the taxpayer must meet all the requirements of 
       the Standard Job Tax Credit.
 ·     An additional annual credit is available for qualified jobs created in Tier 2, Tier 3 and Tier 4 counties.  See Tenn. 
       Code Ann. Section 67-4-2109(b)(2)(A).
 ·     An additional annual credit is available for large investments and higher level of job creation.  This credit requires 
       an investment of at least one-hundred million dollars ($100,000,000) and the creation of at least one-hundred (100) 
       qualified jobs that pay at least the state's average occupational wage, or in the case of a headquarters facility an 
       investment of ten million dollars ($10,000,000) and the creation of at least one-hundred (100) qualified jobs that 
       pay at least 150% the state's average occupational wage.  See Tenn. Code Ann. Section 67-4-2109(b)(2)(B).
 ·     An additional annual credit is available for qualified jobs created in an Adventure Tourism Zone.  See Tenn. Code 
       Ann. Section 67-4-2109(b)(2)(C).
 ·     This credit can be used to offset up to 100% of the franchise and excise tax.  However, any unused credit cannot 
       be applied to other tax years.
General Requirements - Job Tax Credit for Hiring Persons with Disabilities
 ·     In order to qualify for the Job Tax Credit for Hiring Persons with Disabilities the taxpayer must hire workers with 
       disabilities through an existing State of Tennessee employment incentive program.  In order to qualify for the $5,000 
       credit, the employee must work full-time and be covered by the employer's health care plan.  In order to qualify for 
       the $2,000 credit, the employee must work at least 10 hours per week.  Employees who work full-time, but are not 
       covered by the employer's health care plan are treated the same as part-time employees for the purpose of this 
       credit.  See Tenn. Code Ann. Section 67-4-2109(f)(2).
 ·     There is no investment or minimum number of jobs required for this credit.
General Requirements - Community Resurgence Job Tax Credit
 ·     In order to qualify for the Community Resurgence Job Tax Credit the taxpayer must create at least 10 full-time jobs 
       in a high-poverty area with wages equal to, or greater than, the state's average occupational wage.  A list of census 
       tracts that meet the definition of high-poverty areas is provided by the Tennessee Department of Economic and 
       Community Development.
 ·     There is no investment requirement for this credit.  See Tenn. Code Ann. Section 67-4-2109(q).

Line by Line Instructions  

Part 1 - Standard Job Tax Credit
Line 1  Enter the number of net new qualified full-time Tennessee jobs created and filled during the current fiscal year that 
       meet all statutory requirements for the credit at the rate of $4,500 per job.  Taxpayers that qualify for the higher 
       level of investment and job creation additional annual credit should not enter any jobs on this line, but instead 
       should report all jobs on line 3.  The jobs receiving the additional annual credit will receive credit at the rate of 
       $5,000 per job under the provisions of Tenn. Code Ann. Section 67-4-2109(b)(3)(A).
Line 2  Multiply the number on Line 1 by $4,500. 
Line 3   Enter the number of net new full-time Tennessee jobs created and filled during the current fiscal year by a taxpayer 
       that qualifies for the additional annual credit for higher level of investment and job creation under the provisions 
       of Tenn. Code Ann. Section 67-4-2109(b)(2)(B). Taxpayers that qualify for this additional annual credit should enter 
       all new jobs on this line, and taxpayers that do not qualify for the additional annual credit should enter all new 
       jobs on Line 1.

Line 4   Multiply the number on Line 3 by $5,000. 
Line 5   Enter the Job Tax Credit carryover amount from the last page of this schedule.
Line 6  Add the amounts from Lines 2, 4, and 5. 
Line 7  Enter the total Franchise and Excise taxes shown on page one of the return, before credits or payments have been 
deducted.   Schedule A, Line 3 plus Schedule B, Line 5.
Line 8  Enter the limitation percentage.  The limitation percentage is 50% for periods ended on or after July 1, 2009 unless 
the Commissioner of Revenue and the Commissioner of Economic and Community Development have determined 
that it is in the best interests of the state to allow a higher percentage and  issued the taxpayer a letter stating such 
under the provisions of Tenn. Code Ann. Section 67-4-2109(b)(3)(F). 
Line 9  Multiply Line 7 by Line 8. 
Line 10 Enter the lesser of Lines 6 and 9.  Also enter this amount on Part 5, Line 40.

Part 2 - Additional Annual Credit
Line 11 Enter the number of jobs qualifying for the additional annual credit in Tier 2, Tier 3, and Tier 4 Enhancement 
Counties.  Do not include any jobs on this line that are included in Line 13 or 15.  See Tenn. Code Ann. Section 67-
4-2109(b)(2)(A) for further information. 
Line 12 Multiply the number on Line 11 by $4,500. 
Line 13 Enter the number of jobs qualifying for the additional annual credit based on a higher level of investment and job 
creation under the provisions of Tenn. Code Ann. Section 67-4-2109(b)(2)(B).  Do not include any jobs on this line 
that are included in Line 11 or 15. 
Line 14 Multiply the number on Line 13 by $5,000. 
Line 15 Enter the number of jobs qualifying for the additional annual credit in an Adventure Tourism Zone.  Do not include 
any jobs on this line that are included in Line 11 or 13.  See Tenn. Code Ann. Section 67-4-2109(b)(2)(C) for further 
information. 
Line 16 Multiply the number on Line 15 by $4,500. 
Line 17 Add Lines 12, 14, and 16.  Also enter this amount on Part 5, Line 37.  The additional annual credit calculated in Part 
2 can be used to offset up to 100% of the current year Franchise and Excise tax liability.  Any remaining additional 
annual credit is not refundable and cannot be carried forward. 

Part 3 - Job Tax Credit for Hiring Persons with Disabilities
Line 18 Enter the number of net new full-time Tennessee jobs created and filled by persons with disabilities during the 
current fiscal year.  Only include employees for whom health insurance is provided.  If health insurance is not 
provided, the job should be claimed on Line 20. 
Line 19 Multiply the number on Line 18 by $5,000. 
Line 20 Enter the number of net new part-time Tennessee jobs created and filled by persons with disabilities during the 
current fiscal year.  Include full-time employees with disabilities for whom health insurance is not provided.
Line 21 Multiply the number on Line 20 by $2,000. 
Line 22 Enter the Job Tax Credit for Hiring Persons with Disabilities carryover from the last page of this schedule. 
Line 23 Add the amounts from Lines 19, 21, and 22. 
Line 24 Enter the total Franchise and Excise taxes shown on page one of the return, before credits or payments have been 
deducted.   Schedule A, Line 3 plus Schedule B, Line 5. 
Line 25 Enter the limitation.  The limitation is 50% of Line 24. 
Line 26 Enter the lesser of Lines 23 and 25.  Also enter this amount on Part 5, Line 41.

Part 4 - Community Resurgence Job Tax Credit
Line 27 Enter the number of net new qualified Tennessee jobs created and filled during the current fiscal year in a high-
poverty area.  
Line 28 Multiply the number on Line 27 by $2,500. 
Line 29 Enter the Community Resurgence Job Tax Credit carryover from the last page of this schedule. 
Line 30 Add the amounts from Lines 28 and 29. 
Line 31 Enter the total Franchise and Excise taxes shown on page one of the return, before credits or payments have been 
deducted. 
Line 32 Enter the limitation.  The limitation is 50% of Line 31. 
Line 33 Enter the lesser of Lines 30 and 32.  Also enter this amount on Part 5, Line 42.

Part 5 - Calculation of Overall Limitation
Line 34 Enter the total Franchise and Excise taxes shown on page one of the return, before credits or payments have been 
  deducted.   Schedule A, Line 3 plus Schedule B, Line 5.
Line 35 Enter the sum of Gross Premiums Tax credit claimed on Schedule D, Line 1. 
Line 36 Subtract Line 35 from Line 34; if negative, enter zero.
Line 37 Enter the total Additional Annual Credit from Part 2, Line 17.
Line 38 Enter the lesser of Line 36 and 37.  Also enter this amount on FAE170, Schedule D, Line 7 or FAE174, Schedule D, 
  Line 7.  This is the total amount of Additional Annual Credit that can be deducted on this return.
Line 39 Subtract Line 38 from Line 36.  
Line 40 Enter the Standard Job Tax Credit from Part 1, Line 10.
Line 41 Enter the Job Tax Credit for Hiring Persons with Disabilities from Part 3, Line 26.
Line 42 Enter the Community Resurgence Job Tax Credit from Part 4, Line 33.
Line 43 Enter the sum of lines 40 through 42.
Line 44 Enter the sum of all credits claimed on FAE170, Schedule D, Lines 2,3,4, and 5 or FAE174, Schedule D, Lines 
  2, 3, 4 and 5.   Industrial Machinery and Job Tax Credits are applied last since they have the longest carryover period 
  and it is usually in the taxpayer’s best interest to apply the other credits first.
Line 45 Subtract Line 44 from Line 39.  If negative, enter 0.
Line 46 Enter the lesser of Lines 43 and 45.  Also enter this amount on FAE170, Schedule D, Line 6 or FAE174 Schedule D, 
  Line 6.

Part 6 - Supplemental Information
Line a  Enter the control number received from the Department of Revenue.  If more than one control number has been 
  received, enter the most recent number.
Line b  Enter the number of full-time Tennessee jobs that existed at the beginning of the period covered by this return.
Line c  Enter the number of full-time Tennessee jobs that existed at the end of the period covered by this return.