Clear Form
                                                                                 
SCHEDULE PTE-U                          STATE OF HAWAII — DEPARTMENT OF TAXATION                                                                                        TAX YEAR
(2023)
                            UPPER-TIER PASS-THROUGH ENTITY 
                                                                                                                                                                        20__ 
                                        TAX CREDIT ALLOCATION
                                        † Attach to Form N-20 or Form N-35
SCHPTEU_I 2023A 01 VID01
Check    if:  Supplement to Part II Only
Name as shown on tax return                                                        Federal Employer I.D. No. (FEIN)

  Part      I PTE TAX CREDIT RECEIVED FROM ELECTING PTE OR LOWER-TIER PTE INFORMATION
Electing PTE or Lower-Tier PTE Name                                                FEIN

1.   Total PTE tax credit amount received from the electing PTE or lower-tier PTE ........................................................                             1
 Part       IISCHEDULE OF QUALIFIED MEMBERS

1.   Total number of your qualified members reported on this form .................................................................................                    1

2.   Total PTE tax credit amount for all qualified members reported on this form ............................................................                          2
             Qualified Member Name                                                 FEIN

   A                                                                               SSN

             Distributive share of the PTE tax credit ................................................................................................................ A
             Qualified Member Name                                                 FEIN

   B                                                                               SSN

             Distributive share of the PTE tax credit ................................................................................................................ B
             Qualified Member Name                                                 FEIN

   C                                                                               SSN

             Distributive share of the PTE tax credit ................................................................................................................ C
             Qualified Member Name                                                 FEIN

   D                                                                               SSN

             Distributive share of the PTE tax credit ................................................................................................................ D
             Qualified Member Name                                                 FEIN

   E                                                                               SSN

             Distributive share of the PTE tax credit ................................................................................................................ E
             Qualified Member Name                                                 FEIN

   F                                                                               SSN

             Distributive share of the PTE tax credit ................................................................................................................ F
             Qualified Member Name                                                 FEIN

   G                                                                               SSN

             Distributive share of the PTE tax credit ................................................................................................................ G
             Qualified Member Name                                                 FEIN

   H                                                                               SSN

             Distributive share of the PTE tax credit ................................................................................................................ H
                                                                                                                                                                       SCHEDULE PTE-U (2023)

PTU1H7V9                                             ID NO 01

SCHEDULE PTE-U                                                                                                                                                   Page 2
(2023)

SCHPTEU_I 2023A 02 VID01
Name as shown on tax return                             Federal Employer I.D. No. (FEIN)

 Part IISCHEDULE OF QUALIFIED MEMBERS - continued
      Qualified Member Name                             FEIN

 I                                                      SSN

      Distributive share of the PTE tax credit ................................................................................................................ I
      Qualified Member Name                             FEIN

 J                                                      SSN

      Distributive share of the PTE tax credit ................................................................................................................ J
      Qualified Member Name                             FEIN

 K                                                      SSN

      Distributive share of the PTE tax credit ................................................................................................................ K
      Qualified Member Name                             FEIN

 L                                                      SSN

      Distributive share of the PTE tax credit ................................................................................................................ L
      Qualified Member Name                             FEIN

 M                                                      SSN

      Distributive share of the PTE tax credit ................................................................................................................ M
      Qualified Member Name                             FEIN

 N                                                      SSN

      Distributive share of the PTE tax credit ................................................................................................................ N
      Qualified Member Name                             FEIN

 O                                                      SSN

      Distributive share of the PTE tax credit ................................................................................................................ O
      Qualified Member Name                             FEIN

 P                                                      SSN

      Distributive share of the PTE tax credit ................................................................................................................ P
      Qualified Member Name                             FEIN

 Q                                                      SSN

      Distributive share of the PTE tax credit ................................................................................................................ Q
      Qualified Member Name                             FEIN

 R                                                      SSN

      Distributive share of the PTE tax credit ................................................................................................................ R
      Qualified Member Name                             FEIN

 S                                                      SSN

      Distributive share of the PTE tax credit ................................................................................................................ S
                                                                                                                                                                SCHEDULE PTE-U (2023)
PTU2H7V9                                      ID NO 01