Arizona Form               Credit for Qualified Facilities – 
               349-S             Distribution to Shareholders of an S Corporation                                                       2022

   For the calendar year 2022 or fiscal year beginning M M D D 2 0 2 2  and ending              M M D D Y Y Y Y  .
S Corporations:
   • Complete Form 349-S for each shareholder of the S Corporation except for trust or estate shareholders.  
   However, an S Corporation ownership share that is owned by a grantor trust that is disregarded for federal 
   income tax purposes is treated as owned by the grantor.  The grantor may claim his or her share of the credit.
   • Provide a copy of the completed form and the Certification of Qualification received from the Arizona 
   Commerce Authority to each shareholder.
   • Keep a copy of each completed Form 349-S for your records.
   • Include a copy of each completed Form 349-S with your S Corporation return.

Shareholders:
   • Use this form to complete your own Form 349.
   • Include this completed form and a copy of the Certification of Qualification received from the Arizona 
   Commerce Authority with your return.
   • Keep a copy of this form and certificate for your records.

NOTE:  If you file your tax return on a calendar year basis but this entity files a return on a fiscal year basis (see above), 
claim this credit on your tax return for the year in which this entity’s fiscal year ends.

Part 1 Distribution of the Credit
Complete Part 1 to distribute the credit to shareholders of the S Corporation.
   (a) S Corporation Name                              (b) Employer Identification Number (EIN) (c) Post-Approval Number
1
   (a) Shareholder Name                                (b) Taxpayer Identification Number (TIN)
2

3a S Corporation credit amount from Form 349, Part 3, line 11 ...................................................                  3a $     00

3b Shareholder’s ownership percentage ......................................................................................       3b       %
3c Multiply the amount on line 3a by the percentage on line 3b.  Enter the result.  This is the 
   shareholder’s portion of the credit.  ......................................................................................... 3c $     00
   Shareholder:
   The amount reported on line 3c is your portion of this credit. Enter the amount from line 3c on Part 1, line 5 of your 
   Form 349 to claim this credit.

Part 2 Notification of Credit Recapture
Complete Part 2 to notify each shareholder of the S Corporation of his or her share of the credit to be recaptured.

   (a) S Corporation Name                                      (b) Employer Identification Number (EIN)
4
   (a) Shareholder Name                                        (b) Taxpayer Identification Number (TIN)
5
   (a) Post-Approval Number                                    (b) Date the Certification was Terminated or Revoked
6                                                              M M D D Y Y Y Y

7  Shareholder’s portion of the credit to be recaptured ...............................................................            7  $     00
   Shareholder:
   The amount reported on line 7 is your portion of this credit to be recaptured. Enter the amount from line 7 on Part 4, 
   line 15 of your Form 349.

ADOR 11298 (22)