Schedule

                      Community Rehabilitation Program Credit
     CM                       Enclose2024                                                           with Wisconsin Form 1, 1NPR, 2, 3, 4, 4T, 5S, or 6 
     Wisconsin 
Department of Revenue            Read instructions before filling in this schedule
Name                                                                              Identifying Number

Part I – To be completed by claimant

1    Enter amount paid in the taxable year to a community rehabilitation
     program to perform work for your business. Do not fill in more than $500,000   1

  2  Multiply line 1 by 5% (0.05).......................................             2

  3  If you paid an amount to more than one community rehabilitation program
     to perform work for your business, fill in the amount from line 2 of any
     additional Schedules CM ........................................               3

  4  Community rehabilitation program credit passed through from other 
     entities:

4a  Entity Name

     FEIN                                      Amount 4a

4b  Entity Name

     FEIN                                      Amount 4b

4c  Total pass through credits from additional schedule.  4c

  4d Total credits (add lines 4a through 4c)   ............................          4d

  5  Add.........                                                                    5              lines 2, 3, and 4d.  This is your 2024 credit (see instructions) 

  5a Fiduciaries – enter the amount of credit allocated to beneficiaries .........   5a

  5b Fiduciaries – subtract line 5a from line 5  ............................        5b

  6  Carryover of unused community rehabilitation program credit. Include 
     Schedule CF .................................................                   6

  7  Add lines 5 and 6 (lines 5b and 6 if fiduciary). This is the available
     community rehabilitation program credit. Include Schedule CF if the credit 
     was not used in full .............................................             7

IC-234 (R.6-24)

2024 Schedule CM    Name                                                   ID Number                            Page 2 of 2 

Part II – To be completed by the community rehabilitation program

  1  Name and address of entity providing the community rehabilitation program
     Name

     Number and Street                                                                              Suite Number

     City                                                                  State                    Zip Code

    2Name of entity for which work was provided

 3   Taxable year of entity beginning                                      and ending 
                                        M  M  D   D Y Y               Y  Y            M M  D D Y  Y Y Y 
    4Date contract signed
                              M M  D D  Y  Y  Y Y 
    5Total payments received during the period listed in 3 above ................              5

  6  Amount of payments in 5 above that was for work performed...............                    6

           Authorized community rehabilitation program representative                          Date
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