STATE OF DELAWARE                                                                                         DIVISION OF REVENUE
   FORM 1801AC 0009                     APPLICATION AND COMPUTATION SCHEDULE FOR CLAIMING                     820 North French St.
                                                                                                              P.O. Box 8763
                               DELAWARE LAND & HISTORIC RESOURCE CONSERVATION TAX CREDITS                    Wilm DE.,       19899-8763

   FORM 1801AC MUST BE COMPLETED AND SUBMITTED ON OR BEFORE JANUARY 31ST AFTER THE END OF THE CALENDAR 
          YEAR DURING WHICH THE QUALIFIED LAND WAS CONVEYED TO A QUALIFIED CONSERVATION AGENCY.
PART A - NAME AND ADDRESS OF APPLICANT
1.  Enter Federal Employer Identification Number     or    Social Security Number                                      Tax Period Ending Date

   1 ---                                             2 ---

2. Type of Entity:           CCorporation               SCorporation              Partnership                 Individual/Sole Proprietor

   Estate/Trust              DecedentEstate             OtherPass-Through Entity:
                                                                                                         (Enter typeof entity)
3. Name of Applicant

4. Address

   City                                              State           Zip

5. Delaware Address
   (If different from above)
                                                                                               
   City                                              State           Zip

6.  ContactPerson
                                                                           TelephoneNumber
   E-mailAddress
                                                                                 FaxNumber

PARTB – DELAWARELAND &HISTORICRESOURCECONSERVATIONTAXCREDITCOMPUTATION

1.     FairMarket Valueof QualifiedLandConveyed toaQualifiedConservationAgency                              $ _________________
        (Pleaseattachacopyoftheformalappraisal)
2.     MultiplyLine1by40%                                                                                                              .40

3.     DelawareLand&HistoricResourceConservationTaxCredit BeforeLimitation                                  $ _________________

4.     MaximumAmount of Credit                                                                              $                 50,000

5.     Delaware Land & Historic Resource Conservation Credit.   Enter theSmaller of Line3or Line4.          $ _________________
STOP: IF THE TYPE OF ENTITY APPLYING FOR THE CREDIT IS:
• C CORPORATION – Enter the amount from Line 5 on Form 700, Delaware Income Tax Credit Schedule, Line 17(a).
• S CORPORATION – Multiply the amount on Line 5 by the percentage of stock owned by each shareholder.  Enter the result on Form 700, Delaware Income   
                     Tax Credit Schedule, Line 17(b).
• PARTNERSHIP – Multiply the amount on Line 5 by the percentage ownership of each partner.  Enter the result on Form 700, Delaware Income Tax Credit  
                   Schedule, Line 17(c).
• INDIVIDUAL & SOLE PROPRIETOR – Enter the amount from Line 5 on Form 700, Delaware Income Tax Credit Schedule, Line17(d).
• RESIDENT & NONRESIDENT ESTATES & TRUSTS – Multiply the amount on Line  5 by the percentage share of each beneficiary. Enter the result on Form  
                                                      700, Delaware IncomeTax Credit Schedule, Line17(e).
• RESIDENT & NONRESIDENT DECEDENT ESTATES – Enter the amount from Line 5 on Form 700, Delaware Income Tax Credit Schedule, Line17(f).
THE TOTAL AMOUNT OF CREDITS APPROVED BY THE DIRECTOR WITH RESPECT TO ALL APPLICANTS FOR THE DELAWARE LAND & HISTORIC
RESOURCE CONSERVATION TAX CREDITS SHALL NOT EXCEED $1,000,000 IN ANY CALENDAR YEAR.  IF THE AMOUNT OF DELAWARE LAND &
HISTORIC RESOURCE CONSERVATION TAX CREDITS FOR WHICH ALL TAXPAYERS APPLIED IN ANY CALENDAR YEAR EXCEEDS $1,000,000, THEN
THE DELAWARE LAND& HISTORICRESOURCE CONSERVATIONTAX CREDITS TOBE RECEIVEDBY EACHAPPLICANTSHALLBETHEPRODUCTOF
$1,000,000 MULTIPLIED BY A FRACTION, THE NUMERATOR OF WHICH IS THE ELIGIBLE DELAWARE LAND & HISTORIC RESOURCE CONSERVATION
TAX CREDIT APPLIEDFORBY THE APPLICANT ANDTHE DENOMINATORIS THE TOTALOFALLELIGIBLE DELAWARE LAND& HISTORICRESOURCE
CONSERVATIONTAXCREDITSAPPLIEDFORBYALLAPPLICANTS.

                   NAME                                              TITLE                                                    DATE

          Revised12/31/13                                                        *DF41713019999*

                                       GENERAL INSTRUCTIONS FOR COMPLETION OF 
                                                               FORM 1801AC 0009 
 
The Delaware State Historic Preservation Office must first approve the Delaware historic property.  After receiving a Certificate of Completion from 
the Delaware State Historic Preservation Office, Delaware Form 1811AC must be completed by the taxpayer and sent, along with the Certificate of 
Completion, to the Delaware Division of Revenue for tax credit approval.  After receiving tax  credit approval from the Delaware Division of 
Revenue, the approved amount of credit must be transferred to the appropriate line on Delaware Form 700.  Delaware Forms 700 and           
1811AC must be attached to each annual income tax return approved for  the credit.  If you need assistance completing this form, please 
contact Delaware Division of Revenue, 820 N. French Street, Wilmington, DE  19801, email at DOR_CorpTax@Delaware.gov 
 
                                                   SPECIFIC INSTRUCTIONS 
 
PART A - NAME AND ADDRESS OF APPLICANT  
 
Line 1. Enter the Federal Employer Identification or Social Security Number of the person or entity  applying for the credit and the tax year ending 
        date in which the credit is being claimed. 
 
Line 2. Select the type of entity that is claiming the credit. 
 
Line 3. Enter the name of the person or entity claiming the credit. 
 
Line 4. Enter the address of the person or entity claiming the credit. 
 
Line 5.  Enter the location of the qualified historic property, if different from Line 3.   
 
Line 6. Enter the name of the person responsible for completing Form 1811AC.  Also include the telephone number, fax  number and e-mail 
        address of the person. 
 
PART B – COMPUTATION OF THE DELAWARE LAND & HISTORIC RESOURCE CONSERVATION TAX CREDIT 
 
Line  1.  Enter the fair the market value of the qualified land conveyed to a qualified conservation agency.  Please attach a copy of the  formal     
         appraisal of the qualified land. Please identify the qualified conservation agency to which the land is being conveyed. 
 
Line 2. The percentage of the fair market value of the qualified land to be tax deductible. 
 
Line 3. Multiply Line 1 by Line 2.  This is the Delaware Land and Historic Resource Conservation tax credit before credit limitation. 
 
Line 4. Maximum amount of credit. 
 
Line 5. This is your Delaware Land and Historic Resource Conservation Tax Credit. Enter the smaller of Line 3 or Line 4. 
 
STOP: IF THE TYPE OF ENTITY APPLYING FOR THE CREDIT IS: 
 
        • C CORPORATION – Enter the amount from Line 5 on Form 700, Delaware Income Tax Credit Schedule, Line 17(a).
        • S CORPORATION – Multiply the amount on Line 5 by the percentage of stock owned by each shareholder.  Enter the result
          on Form 700, Delaware Income Tax Credit Schedule, Line 17(b).
        • PARTNERSHIP – Multiply the amount on Line 5 by the percentage ownership of each partner.  Enter the result on Form 
          700, Delaware Income Tax Credit Schedule, Line 17(c).
        • INDIVIDUAL/SOLE PROPRIETOR:  Enter the amount from Line 5 on Form 700, Delaware Business Tax Credit
          Schedule, Line 17(d).
        • RESIDENT & NONRESIDENT ESTATES & TRUSTS – Multiply  the amount from Line 5 by the percentage share
          of each beneficiary. Enter the result on Form 700, Delaware Income Tax Credit Schedule, Line 17(e).
        • RESIDENT & NONRESIDENT DECEDENT ESTATES – Enter the amount from Line 5 on Form 700, Delaware
          Income Tax Credit Schedule, Line 17(f).
 
THE TOTAL AMOUNT OF CREDITS APPROVED BY THE DIRECTOR WITH RESPECT TO ALL APPLICANTS FOR THE DELAWARE LAND & 
HISTORIC RESOURCE CONSERVATION TAX CREDITS SHALL NOT EXCEED $1,000,000 IN ANY CALENDAR YEAR.  IF THE AMOUNT OF  
DELAWARE LAND & HISTORIC RESOURCE CONSERVATION TAX CREDITS FOR WHICH ALL TAXPAYERS APPLIED IN ANY CALENDAR 
YEAR EXCEEDS $1,000,000, THEN THE DELAWARE LAND & HISTORIC RESOURCE CONSERVATION TAX CREDITS TO  BE RECEIVED 
BY EACH APPLICANT SHALL BE THE PRODUCT OF $1,000,000 MULTIPLIED BY A FRACTION, THE NUMERATOR OF WHICH IS THE 
ELIGIBLE DELAWARE LAND & HISTORIC RESOURCE CONSERVATION TAX CREDIT APPLIED FOR BY THE APPLICANT AND THE 
DENOMINATOR IS THE TOTAL OF ALL ELIGIBLE DELAWARE LAND & HISTORIC RESOURCE CONSERVATION TAX CREDITS APPLIED 
FOR BY ALL APPLICANTS.