Use your mouse or Tab key to move through the fields. Use your mouse or space bar to enable check boxes.

                                                                                           *62312221W*

        Illinois Department of Revenue                                                      
                                                                                                                                                                                                        
        Schedule 4255                                              Recapture of Investment Tax Credits
        Attach to Form IL-1040, IL-1120, IL-1065, 
        IL-1120-ST, IL-1041, or IL-990-T.                                                                                                            IL Attachment No. 4                                       
 
Enter your name as shown on your return.                                                          Enter your Social Security number (SSN) or federal employer identification number (FEIN).
The property you are reporting on Steps 1 through 4 of this schedule was placed in service during the tax year ending:                                               
                                                                                                                                                         Month                                          Year 

Step 1:  Figure your Enterprise Zone or River Edge Redevelopment Zone 
          Investment Credit recapture
        A                    B                  C                     D                      E                F                                  G             H 
  Date property placed Date property            Description of        Reason for           Original basis    Name of enterprise                Credit         Disqualified 
   in service in Illinois  became disqualified  qualified property    disqualification                       zone or river edge                 rate          credit amount
      Month   Year     Month   Year                                                                          redevelopment zone                               (Col. E x Col. G)
  1  a                                                                                                                                                                                                         
    b                                                                                                                                                                                                          
    c                                                                                                                                                                                                          
    d                                                                                                                                                                                                          
    e                                                                                                                                                                                                          
    f                                                                                                                                                                                                          

  2  Add Column H, Lines 1a through 1f. Enter the Column H total on Line 11, Column A.                                                             2                                                          

Step 2:    Figure your High Impact Business Investment Credit recapture
        A                    B                  C                     D                      E                F                                  G             H 
  Date property placed Date property            Description of        Reason for           Original basis    Name of the                       Credit         Disqualified
    in service in Illinois  became disqualified qualified property    disqualification                       foreign trade zone/                rate          credit amount
      Month   Year     Month   Year                                                                          sub-zone                                         (Col. E x Col. G)
  3 a                                                                                                                                             .005                                                         
   b                                                                                                                                           .005                                                            
   c                                                                                                                                           .005                                                            
    d                                                                                                                                          .005                                                            
    e                                                                                                                                          .005                                                            
    f                                                                                                                                          .005                                                            
    
  4  Add Column H, Lines 3a through 3f.  Enter the Column H total on Line 11, Column B.                                                              4                                                        

Step 3:  Figure your REV Illinois Investment Credit recapture
        A                    B                  C                     D                      E                F                                  G             H 
  Date property placed Date property            Description of        Reason for           Original basis    Location of REV                   Credit         Disqualified 
   in service in Illinois  became disqualified  qualified property    disqualification                       Illinois Project                   rate          credit amount
      Month   Year     Month   Year                                                                                                                           (Col. E x Col. G)
  5 a                                                                                                                                           .005                                                     
   b                                                                                                                                            .005                                                     
   c                                                                                                                                            .005                                                     
   d                                                                                                                                            .005                                                     
    e                                                                                                                                           .005                                                     
    f                                                                                                                                           .005                                                     

  6   Add Column H, Lines 5a through 5f. Enter the Column H total on Line 11, Column C.                                                                  6                                                    

                                                   This form is authorized as outlined by the Illinois Income Tax Act. Disclosure of this 
        Schedule 4255 (R-12/22)                    information is REQUIRED. Failure to provide information could result in a penalty.                    Page 1 of 3

                                                                                           *62312222W*

Step 4:  Figure your Replacement Tax Investment Credit recapture
      A                   B                   C                                          D                       E                          F                   G 
     Date property placed Date property       Description of                            Reason for               Original basis             Credit              Disqualified       
  in service in Illinois  became disqualified qualified property                     disqualification                                       rate                credit amount
      Month   Year        Month   Year                                                                                                                          (Col. E x Col. F)
  7 a                                                                                                                                                                             
    b                                                                                                                                                                             
    c                                                                                                                                                                              
    d                                                                                                                                                                              
    e                                                                                                                                                           
    f                                                                                                                                                        
                                                                                                                                                     
 8   Add Column G, Lines 7a through 7f. Enter the Column G total on Line 11, Column D.                                                                8                           

Step 5:   Figure your total Enterprise Zone Investment Credit, or River Edge 
        Redevelopment Zone Investment Credit, High  Impact Business Investment 
        Credit, REV Illinois Investment Credit, and Replacement Tax Investment 
        Credit recapture amount 
                                                                                           A                     B                          C                         D
                                                                                      Enterprise Zone            High Impact          REV Illinois              Replacement Tax
                                                                                        or River Edge            Business             Investment                Investment
                                                                                       Redevelopment   Investment Credit                    Credit              Credit
                                                                                     Zone Investment             recapture            recapture                 recapture
                                                                                     Credit recapture
 9  Enter the total basis of all your property. See instructions.      9                                                                                    
 10 Enter the amount of your original credit. See instructions.                     10                                                                  
 11  Enter the total disqualified credit amounts from 
   Steps 1, 2, 3, and 4.                                                            11                                                                  
 12 Subtract Line 11 from Line 10. This is your adjusted credit.                    12                                                                                               
 13  Enter your original tax amount. See instructions.                  13                                                                              
 14  Enter the lesser of Line 10 or Line 13.                                          
   This is the amount of credit you previously used.                          14                                                                        
 15  Subtract Line 12 from Line 14. If the result is 
   negative, enter zero.                                                 15                                                                             
 16 Enter the amount of recapture from any other 
   Schedule 4255 filed this year. See instructions.                   16                                                                                
 17  Distributive share of recapture from partnerships 
   and S corporations from Schedule(s) K-1-P.                          17                                                                               
 18  Add Lines 15, 16, and 17.                                                      18                                                                                                         
 19 Partnerships and S corporations - Enter the amount 
   from Line 18 that you passed through to your partners 
   or shareholders. See instructions.                                               19                                                                                               
 20  Total Enterprise Zone Investment Credit or River Edge Redevelopment 
   Zone Investment Credit, High Impact Business Investment Credit, 
   REV Illinois Investment  Credit, and Replacement Tax Investment 
   Credit recapture. Subtract Line 19 from Line 18. 
   See instructions.                                                                20                                                                  

       If you attach multiple Schedules 4255, complete Step 6 only on the last succeeding Schedule 4255 you complete. If you do not have any 
additional income tax credit recapture amounts, do not complete Step 6.

      Page 2 of 3                             Printed by the authority of the state of Illinois - electronic only - one copy.               Schedule 4255 (R-12/22)   

                                             *62312223W*

Step 6:   Figure your additional income tax credit recapture amount
 21   Enter the amount of Angel Investment Credit claimed for any prior year. See instructions.                  21 
 22    Enter the amount of EDGE Credit claimed for any prior year. See instructions.                             22 
   23  Enter the amount of New Construction EDGE Credit claimed for any prior year. See instructions.            23 
 24  Enter the amount of Historic Preservation Credit claimed for any prior year. See instructions.              24 
 25   Enter the amount of New Markets Development Credit claimed for any prior year. See instructions.           25 
 26   Enter the distributive share of additional income tax credit recapture from partnerships and S corporations
   from Schedule(s) K-1-P.                                                                                       26 
 27  Total income tax credit recapture. Add Lines 21, 22, 23, 24, 25, and 26. See instructions.                  27 

       Schedule 4255 (R-12/22)                                                                                   Page 3 of 3
                                       Reset Print