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                                       STATE OF HAWAII — DEPARTMENT OF TAXATION
 FORM
                            INFORMATION STATEMENT
 N-756A                                CONCERNING THE ENTERPRISE ZONE TAX CREDIT
                            (TO BE FURNISHED TO PARTNERS OF PARTNERSHIPS, SHAREHOLDERS OF S                                                                                                 20__
 (Rev. 2018)                           CORPORATIONS, OR BENEFICIARIES OF ESTATES & TRUSTS)
                       Or fiscal year beginning _______________, 20_______, and ending _______________, 20_______.
Name (Partnership, S Corporation, Estate, or Trust)
                                                                                                                  £  Partnership

Number and Street
                                                                                                                  £  S Corporation

City or Town, State and Postal/Zip Code
                                                                                                                  £  Estate or Trust

Name of individual or corporation for whom this statement is being prepared.                                      SSN or FEIN

 INSTRUCTIONS: EVERY PARTNERSHIP, S CORPORATION, ESTATE OR TRUST (ENTITY) IS REQUIRED TO PREPARE THIS STATEMENT 
 FOR EACH PARTNER, SHAREHOLDER, OR BENEFICIARY (MEMBER), RESPECTIVELY, IN ORDER THAT THE ENTITY’S ENTERPRISE ZONE 
 TAX CREDIT MAY BE CLAIMED BY THE MEMBER.  ATTACH A COPY OF THE CERTIFICATION ISSUED BY THE DEPARTMENT OF BUSINESS, 
 ECONOMIC DEVELOPMENT & TOURISM.  REFER TO THE INSTRUCTIONS FOR FORM N-756 FOR MORE INFORMATION.

 MEMBERS: USE THE INFORMATION PROVIDED ON THIS STATEMENT TO FILL OUT FORM N-756 WHICH IS TO BE ATTACHED 
 TO YOUR RETURN TO CLAIM YOUR SHARE OF THIS CREDIT.  ALSO ATTACH A COPY OF THIS FORM AND THE CERTIFICATION 
 ISSUED BY THE DEPARTMENT OF BUSINESS, ECONOMIC DEVELOPMENT AND TOURISM TO THE RETURN YOU FILE.

1.  Entity’s cycle year(s) contained in the taxable year and the number of months during the taxable year attributable to  
 the cycle year.  Each member shall enter this information on Form N-756, Part II or III, whichever is applicable.
 a. Cycle year  __________  No. of months during the taxable year  _______________
 b. Cycle year  __________  No. of months during the taxable year  _______________

2a. Member’s share of the entity’s total net income attributable to Hawaii.  Each member shall include this amount on Form 
 N-756, line 2b (If this is a loss, enter -0- on Form N-756, lines 2c and 3) .....................................................................................
 b.  Entity’s total gross income from trade or business within the zone ...............................................................................................
 c.  Entity’s total gross income within Hawaii .......................................................................................................................................
 d.  Entity’s percentage of business within the zone.  Divide line 2b by line 2c ...................................................................................
 e.  Member’s share of the entity’s total net income within the zone.  Multiply line 2a by line 2d.  Each member shall include 
 this amount on Form N-756, line 2a ..............................................................................................................................................

3a. Member’s share of unemployment insurance premiums paid for employees employed within Hawaii .........................................
 b.  Entity’s total payroll for employees employed within the zone .......................................................................................................
 c.  Entity’s total payroll for employees employed within Hawaii ..........................................................................................................
 d.  Entity’s percentage of unemployment insurance premiums paid on the payroll of employees employed within the zone. 
 Divide line 3b by line 3c. ................................................................................................................................................................
 e.  Member’s share of the entity’s unemployment insurance premiums paid within the zone.  Multiply line 3a by line 3d.   
 Each member shall enter this amount on Form N-756, line 6.  On the dotted line next to line 6, write “From Form N-756A.” ......

                                                                                                                                                                                            FORM N-756A
N756A_I 2018A 01 VID01                             ID NO 01