Arizona Form Credit for New Employment 2022 345 Include with your return. 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 . Name as shown on Form 140, 140PY, 140NR, 140X, 140-SBI, 140PY-SBI, 140NR-SBI, 140X-SBI, Social Security or 99T, 120, 120A, 120S, 120X, or 165 Employer Identification Number Part 1 Business Information 1 Business Name 2 Business Location Address — Street City State ZIP Code 3 Employer Identification Number 4a What type of entity is the business? C Corporation Exempt Organization Limited Liability Company (LLC) Partnership S Corporation Sole Proprietorship 4b If the business is an LLC, what is the federal tax classification? Check only one box: C Corporation Disregarded Entity Partnership S Corporation If the business is an LLC, a partnership or an S Corporation, include a schedule that lists ownership information including: name, address, TIN, and ownership percentage at the end of the tax year. Part 2 Qualification for Credit 5 Did you receive certification from the Arizona Commerce Authority? .......................................... Yes No If “Yes”, include a copy of the Certification. 6 Are you claiming a pass through of this credit from a partnership and/or an S Corporation? ..... Yes No If “Yes”, include a copy of Form(s) 345-P and/or Form(s) 345-S. 7 If you answered “Yes” to the question on line 5 or on line 6, go to Part 3. If you answered “No” to the questions on line 5 and on line 6, STOP! YOU ARE NOT ELIGIBLE TO CLAIM THIS CREDIT. Part 3 Current Taxable Year’s Credit Calculation (a) (b) Number of Available Credit: Employees Multiply column (a) by $3,000. 8 Credit for employees in first year or partial year of employment in a qualified employment position ................................................................................................................................. 8 00 9 Credit for employees in the second year of continuous employment in a qualified employment position............................................................................................................. 9 00 10 Credit for employees in the third year of continuous employment in a qualified employment position............................................................................................................. 10 00 11 Enter the credit passed through from partnerships on Form(s) 345-P, line 3c .................... 11 00 12 Enter the credit passed through from S Corporations on Form(s) 345-S, line 3c................. 12 00 13 Add lines 8 through 12 in column (b). Enter the total. This is your total current year’s credit for New Employment. ................................................................................................. 13 00 Continued on page 2 ADOR 11149 (22) |
Name (as shown on page 1) TIN Part 4 Partnerships A partnership claiming this credit must pass the credit through to its partners. • Complete Form 345-P for each partner. • Provide a completed copy of Form 345-P to each partner. • Include a copy of each completed Form 345-P with your tax return. • Keep a copy of each completed Form 345-P for your records. • Do not complete Parts 5 through 7 of this form. Part 5 S Corporation Credit Election and Shareholder’s Share of Credit 14 The S Corporation has made an irrevocable election for the taxable year ending M M D D Y Y Y Y to (check only one box): 14a Claim the credit for new employment as shown on Part 3, line 13 (for the taxable year indicated above); OR 14b Pass the credit for new employment as shown on Part 3, line 13 (for the taxable year indicated above) through to its shareholders. Signature Title Date If passing the credit through to the shareholders, complete Form 345-S for each shareholder. • Provide a copy of completed Form 345-S to each shareholder. • Include a copy of each completed Form 345-S with your tax return. • Keep a copy of each completed Form 345-S for your records. Part 6 Available Credit Carryover (a) (b) (c) (d) (e) 15 Taxable year ............... 16 Original credit amount 00 00 00 00 00 17 Amount previously used........... 00 00 00 00 00 18 Tentative carryover: Subtract line 17 from line 16 ................. 00 00 00 00 00 19 Amount disallowed: See instructions .......... 00 00 00 00 00 20 Available carryover: Subtract line 19 from line 18 ................. 00 00 00 00 00 21 Total Available Carryover ................................................................................................................................................ 21 00 Continued on page 3 ADOR 11149 (22) AZ Form 345 (2022) Page 2 of 3 |
Name (as shown on page 1) TIN Part 7 Total Available Credit 22 Current year’s credit for new employment: • Individuals, C Corporations, S Corporations claiming this credit at the corporate level, or exempt organizations with UBTI: Enter the amount from Part 3, line 13, column (b). • Individuals that did not make the Small Business Income election: Also, enter this amount on Form 301, Part 1, line 19, column (a). • Individuals that made the Small Business Income election: Also, enter this information on Form 301-SBI, Part 1, line 14, column (a). • C Corporations, S Corporations claiming this credit at the corporate level, and exempt organizations with UBTI: Also, enter this amount on Form 300, Part 1, line 13, column (a).. ............................................................................. 22 00 23 Available credit carryover from Part 6, line 21, column (e): • Individuals that did not make the Small Business Income election: Also, enter this amount on Form 301, Part 1, line 19, column (b). • Individuals that made the Small Business Income election: Also, enter this amount on Form 301-SBI, Part 1 line 14, column (b) • C Corporations, S Corporations claiming this credit at the corporate level, and exempt organizations with UBTI: Also, enter this credit on Form 300, Part 1, line 13, column (b). ................................................................................. 23 00 24 Total available credit: Add lines 22 and 23 and enter the total. • Individuals that did not make the Small Business Income election: Also, enter total here and on Form 301, Part 1, line 19, column (c). • Individuals that made the Small Business Income election: Also, enter this information on Form 301-SBI, Part 1, line 14, column (c). • C Corporations, S Corporations claiming this credit at the corporate level, and exempt organizations with UBTI: Also, enter this credit on Form 300, Part 1, line 13, column (c). .................................................................................. 24 00 ADOR 11149 (22) AZ Form 345 (2022) Print 345 Page 3 of 3 |
Name (as shown on Form 345) TIN Page of Form 345-1 Employees at Business Location 2022 Complete a Form 345-1 for each employee, whether or not the employee is in a qualified employment position. See instructions 1 Employee name: 2 Employee’s Social Security Number (SSN) .............................................................................................................. 3a What credit year are you claiming for this employee? First Second Third Not qualified for credit, or fourth year or more 3b Is this employee a replacement of another employee who left a qualified employment position in the second or third year? See instructions ........................................................................................................................................ Yes No 3c If the answer to line 3b is “Yes”, did the total time the position was vacant from the date the employment position was originally filled to the end of the current tax year total 90 days or less? See instructions ....................................... Yes No 3d If the answer to line 3c is “Yes”, enter the name of the replaced employee, his or her Social Security Number, and termination date: Employee Name Social Security Number Termination Date M M D D Y Y Y Y 4a Current date of employment ..................................................................................................................................... M M D D Y Y Y Y 4b Termination date, if the employee was terminated before the end of the taxable year ............................................ M M D D Y Y Y Y 4c If the employee was terminated, is he or she replaced by a new hire in the same qualified employment position? Yes No If the answer is “Yes”, enter the name of the new hire, his or her Social Security Number, and hire date: Employee Name Social Security Number Hire Date M M D D Y Y Y Y 5a If employee was previously employed by the business, list the previous date of employment. See instructions. ...... M M D D Y Y Y Y 5b If employee was previously employed by the business, list the date of separation.................................................. M M D D Y Y Y Y 5c Did the employee relocate to this state from out of state? ....................................................................................... Yes No 5d If the employee relocated from out of state, enter date of relocation ....................................................................... M M D D Y Y Y Y 6a Is the employee in a permanent position that consists of at least 1750 hours per year? ......................................... Yes No 6b If the answer to line 6a is “Yes”, list the number of hours the employee actually worked during the taxable year. ...... 7 Are the employee’s job duties performed primarily at the location(s) of the business? ............................................ Yes No 8a Employee’s annual compensation for the taxable year ............................................................................................ $ . 00 8b Employee’s HOURLY wage in dollars and cents ..................................................................................................... $ . 9a Total cost of health insurance provided by employer for employee. See instructions. ............................................... $ . 00 9b Total cost of health insurance for employee paid by employer. See instructions........................................................ $ . 00 10 Is this employee in a new qualified employment position? ....................................................................................... Yes No 11a Has this employee been substituted for another employee in a qualified employment position? ............................ Yes No 11b If answer on line 11a is “Yes”, list the date of substitution M M D D Y Y Y Y and indicate whether the individual is a second year employee or a third year employee. See instructions for the qualification before answering this question. Check only one box: Second year employee Third year employee ADOR 11149 (22) Print 345-1 |
Name (as shown on Form 345) TIN Page of Form 345-2 Employees in Qualified Employment Positions 2022 (a) (b) (c) (d) Employee’s Name Social Security Type of Employee Limitation on Total Number Number of Credits Check the appropriate box. This employee is a: (c1) (c2) (c3) See instructions 1 stYear 2 ndYear 3 Yearrd before checking Employee Employee Employee this box. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 TOTAL: Add lines 1 through 23 including only lines with check marks. Enter the total for each column .............................................................................................................. 24 If you are claiming more than 23 employees in qualified employment positions, complete additional schedules. ADOR 11149 (22) Print 345-2 Clear 345-2 |