Arizona Form  
                                                  Credit for Qualified Facilities                                                                              2020
                349
 Include this completed form and the Certification of Qualification from the Arizona Commerce Authority with your return.

   For the calendar year 2020 or fiscal year beginning       M M D D                                 2 0 2 0  and ending M M D D Y Y Y Y  .
Name as shown on Form 140, 140PY, 140NR, 140X, 99T, 120, 120A, 120S, 120X, or 165                          Social Security or 
                                                                                                           Employer Identification Number

Part 1 Listing of Post-Approved Qualified Facilities and Apportioned Credit Amount
List qualified facilities for which you are entitled to claim a credit during this taxable year. If you have more than two facilities, include 
additional schedules. See instructions.
                                            (a)                                                            (b) 
                Arizona Commerce Authority Post-Approval Information                                   Apportioned Credit Amount
       (a)1                            (a)2                        (a)3 
   Allocation Year     First Installment Tax Year Ending  Post-Approval Number

 1     Y Y Y Y            M M D D Y Y Y Y                                                                                                                    00

 2     Y Y Y Y            M M D D Y Y Y Y                                                                                                                    00

 3 Enter the total from all additional schedules ...........................................         3                                                       00
 4 Enter the total amount of this credit passed through from partnerships on 
   Form 349-P, Part 1, line 3c ..................................................................... 4                                                       00
 5 Enter the total amount of this credit passed through from S corporations on 
   Form 349-S, Part 1, line 3c.....................................................................  5                                                       00
 6 Subtotal:  Add lines 1 through 5, column (b). Enter the total. This is your total 
   apportioned credit amount ......................................................................  6                                                       00

Part 2 Full-Time Employment Positions Vacant More Than 150 Days
List the number of full-time employment positions which were vacant for more than 150 days since the credit was approved.  If positions 
were vacant at more than two facilities, include additional schedules. See instructions.
       (a)                     (b)                           (c)                                       (d)                                                     (e) 
   Allocation Year     Post-Approval Number       Number of Employees                                  Reduction                                               Total

 7     Y Y Y Y                                                                                         $4,000.00                                                    00

 8     Y Y Y Y                                                                                         $4,000.00                                                    00
 9 Total from all additional schedules.....................................................................................................               9         00
10 Subtotal:  Add lines 7 through 9, column (e). Enter the total. This is the amount of your credit 
   reduction ............................................................................................................................................ 10        00

Part 3 Net Credit
11 Subtract the amount on line 10 from the amount on line 6. Enter the difference. If less than                           
   zero, enter “0” ....................................................................................................................................   11        00

Part 4 Credit Recapture
12 Date on which the certification of the business as a qualified facility was terminated or revoked .....                                                12 M M D D Y Y Y Y
13 Total recapture of apportioned credit for qualified facilities:  Enter the total amount(s) of the 
   credit(s) previously claimed for the facility(ies) whose certification was terminated or revoked.  
   If more than one certification has been terminated or revoked, enter the total amount ....................                                             13        00
14 Enter the partner’s portion of this credit to be recaptured from Form 349-P, Part 2, line 7. ..............                                            14        00
15 Enter the S corporation shareholder’s portion of this credit to be recaptured from Form 349-S,  
   Part 2, line 7. .....................................................................................................................................  15        00
16 Add lines 13 through 15.  Enter the total.  This is your total recapture amount .................................                                      16        00
                                                                                                                                                             Continued on page 2 
ADOR 11192 (20)

 Name (as shown on page 1)                                                    EIN

 Part 5   S Corporation Credit Election
 17  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):
      17a  Claim the credit for qualified facilities as shown in Part 3, line 11 (for the taxable year indicated above);
          OR
      17b  Pass the credit for qualified facilities as shown in Part 3, line 11 (for the taxable year indicated above), through to its 
            shareholders.

      Signature                                                 Title Date
If passing the credit through to the shareholders, complete Form 349-S for each shareholder.
      • Provide a completed copy of Form 349-S to each shareholder.
      • Include a copy of each completed Form 349-S with your tax return.
      • Keep a copy of each completed Form 349-S for your records.

 Part 6   Partnerships
Partnerships passing the credit through to its partners, complete Form 349-P for each partner.
      • Provide a completed copy of Form 349-P to each partner.
      • Include a copy of each completed Form 349-P with your tax return.
      • Keep a copy of each completed Form 349-P for your records.

 Part 7   Credit Recapture Summary
 18   Enter the taxable year(s) in which you took a credit for a business as a qualified facility whose 
      certification has been terminated or revoked:

 19  Total amount of credit recaptured:
 • Individuals, C Corporations, S corporations, and exempt organizations with UBTI: 
       Enter the amount from Part 4, line 16.
 • Individuals:  Also, enter this amount on Form 301, Part 2, line 30.
 • C Corporations, S corporations that claimed this credit at the corporate level, and exempt 
       organizations with UBTI:  Also, enter this amount on Form 300, Part 2, line 20 .............................                                  19 00

 Part 8   Total Apportioned Credit Claimed This Taxable Year
 20   Total apportioned credit for qualified facilities:
 • Individuals, C Corporations, S corporations claiming this credit at the corporate level, and 
       exempt organizations with UBTI:  Enter the amount from Part 3, line 11.
 • Partnerships:  Enter “0”.
 • S corporations electing to pass this credit through to individual shareholders:  Enter “0”.
 • Individuals:  Also, enter this amount on Form 140, line 58; or Form 140NR, line 65; or 
       Form 140PY, line 67; or Form 140X, line 43.
 • C Corporations:  Also, enter this amount on Form 120, line 22; or Form 120A, line 14; or 
       Form 120X, line 22(c).
 •     Exempt organizations with UBTI:  Also, enter this amount on Form 99T, line 12.
 • S corporations that claimed this credit at the corporate level:  Also, enter this amount on 
       Form 120S, line 18 .......................................................................................................................... 20           00

 ADOR 11192 (20)                                         AZ Form 349 (2020)                                                                                Page 2 of 2