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                         Missouri Department of Revenue                                                      Department Use Only
               Form      Small Business Deduction For New                                                    (MM/DD/YY)
MO-NJD                   Jobs Under Section 143.173, RSMo.

                    Taxable Year  Beginning                                                                  Ending
                                  (MM/DD/YY)                                                                 (MM/DD/YY)

               Missouri Tax I.D.                                                                  Federal Employer
               Number                                                                             I.D. Number

Name of Small Business                                                                                                                                                                                      Social Security Number (Last 4 Digits)

Address                                                                                      City                                                           State            Zip Code                                                

Type of Small Business
r Sole Proprietor      r Partnership      r C-Corporation      r S-Corporation      r Limited Liability Company     r Limited Liability Partnership       
r Other Business Entity (Specify Business Type) __________________________________________________________

               For all taxable years beginning on or after January 1, 2011 (if pass through entity, see special instructions on page 2), and ending on or before 
               December 31, 2014, if a small business creates new jobs, it may qualify to claim a deduction in the taxable year each new employee completes 
               at least 52 weeks of full-time employment.  The deduction is equal to $10,000 for each new job created or $20,000 for each new job created by 
               a small business that paid at least 50 percent of all employees’ health insurance premiums.
               The Small Business:
                 •  Must employ fewer than 50 full-time or part-time employees at all times during the tax year for which the deduction is requested to 
                   qualify for the deduction. Any small business affiliated with another business must consider each employee of all affiliated businesses 
                   in determining if it employs fewer than 50 full-time or part-time employees.  Two businesses are affiliated if either party has power 
                   to control the other, or a third party controls or has the power to control both parties. For purposes of the deduction, a part-time 
                   employee is defined as one who  works fewer than 30 hours per week.
                 •  Must be subject to income taxes imposed in Chapter 143, RSMo.
                 •  Must ensure all new employees have completed at least 52 weeks of full-time employment prior to including them in 
                   the  deduction  calculation.    Upon  completion  of  at  least  52  weeks,  the  employee  becomes  a  qualifying  full-time  employee  and  the 
                   small business may choose a date to compare the number of qualifying full-time employees employed in the previous calendar year.  See  
                   the example below for further instruction.
                 •  Must pay wages of at least the county average wage or the state average wage if the county wage is in excess of the state wide average. The 
                   county average wage is calculated by the Department of Economic Development and can be found at: 
                 https://meric.mo.gov/data/county-average-wages.
Qualifications   •  Must pay at least 50 percent of the health insurance premium for all full-time employees, not just for new employees, to claim the $20,000  
                   deduction.
               The Employee:
                 •  Must  complete at least 52 consecutive weeks of employment  and work  an average  of at  least 35 hours per week  before the  small 
                   business may claim the deduction.                                                                               
                 •  May  not  have  been  previously  employed  in  Missouri  by  the  small  business  or  any  business  affiliated  with  the  small  business 
                   for a period of 12 months prior to the creation of the new job.  
               Example:  A small business chooses November 1 as its comparison date.  On that date in 2011, the business had 25 full-time employees 
               who had been employed for at least 52 weeks, and five employees who had been employed for 20 weeks.  Also on that date, the business 
               hires two new employees who had not been employed by the business. If all these employees remain employed through November 1, 2012, 
               the small business is eligible to claim deductions for seven of its employees in determining its 2012  tax liability.  Although five 
               of these employees had been employed prior to November 1, 2011, they would not qualify as full-time employees on that date 
               because they had not completed 52 weeks of employment.  Although those five employees could have qualified for the 
               deduction prior to November 1, 2012, the two employees hired on November 1, 2011 could not.  Because a small business can 
               select  only one comparison  date  per  year, the  small  business  selected  November 1,  2012  so  it  could  claim  the  deduction  for  all seven 
               employees.

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                              1.  Comparison Date:  Each small business must choose a date to compare the number of full-time employees in the  
                               deduction year and the number employed in the immediately preceding year.  Enter your comparison date: (MM/DD/YYYY) ..   1                                                                   __ __ /__ __ /__ __ __ __
                              2. Employees in Deduction Year:  The number of full-time employees employed on your comparison date in the deduction year.   2
                              3.  Employees in Previous Year:  The number of full-time employees employed on your comparison date in the immediately 
                               preceding year. .........................................................................................................................................................................   3
                  Instructions
                              4.  Subtract Line 3 from Line 2 to determine the number of eligible employees ............................................................................   4                                  0
                              In the table below, enter the requested information for each new employee reflected on Line 4.
                              Note:  If the employee worked in more than one county, enter the county in which he or she worked for the majority of his or her 52 weeks of employment. 

                              Under penalties of perjury, I declare that the above information and any attached supplement is true, complete, and correct.  I am the owner of or an officer of the 
                              above business and am authorized to apply for the small business deduction for new jobs on behalf of the small business identified above.  I hereby certify to the 
                              Department of Revenue that the employees listed on page 2 meet the requirements outlined in Section 143.173, RSMo, and the small business claiming a deduction 
                              meets the requirements outlined in this document and in Section 143.173, RSMo.
                              Signature                                                                                     Title
         Signature
                              Printed Name                                                                                  Date (MM/DD/YYYY)
                                                                                                                            __ __ /__ __ /__ __ __ __

                                                                                                            County Where         Annual County        Paid For 52  
                               Employee Name               Employee Social            Employee Title or                                              Total Wages                                                               Total
                               First, Middle Initial, Last Security Number            Position Code          Employee Worked     Average Wage        Consecutive                                                              Deduction
                                                           (Last Four Digits)                                                                        Weeks

 1.                                                                                                                          $                  $                                                                           $

  2.                                                                                                                         $                  $                                                                           $

  3.                                                                                                                         $                  $                                                                           $
  4.                                                                                                                         $                  $                                                                           $
  5.                                                                                                                         $                  $                                                                           $
  6.                                                                                                                         $                  $                                                                           $
  7.                                                                                                                         $                  $                                                                           $
  8.                                                                                                                         $                  $                                                                           $

  9.                                                                                                                         $                  $                                                                           $
10.                                                                                                                          $                  $                                                                           $
11.                                                                                                                          $                  $                                                                           $

12.                                                                                                                          $                  $                                                                           $

13.                                                                                                                          $                  $                                                                           $
14.                                                                                                                          $                  $                                                                           $
15.                                                                                                                          $                  $                                                                           $
Total Deduction:  Enter your total deduction here and on Form MO-1040, Line 18B; or on Form MO-1120, Line 7. ...............
If you hired more than ten new employees, please print an additional page(s).                                                                                                                                               $       0.00

Special Instructions for Pass-Through Entities: 
For tax years ending on or after August 28, 2012, S-corporations, limited liability companies, limited liability partnerships or other pass-through business 
entities may also qualify for the small business deduction for new jobs under Section 143.173, RSMo. 
The deduction year comparison date can be any date within the tax year and the previous year comparison date will be one year earlier.  Each partner, 
member or shareholder must attach a completed Form MO-NJD when claiming the small business deduction on their income tax return.

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                                                                        Complete the Allocation Schedule below listing each partner, member, or shareholder and their applicable amount of the total small business deduction 
                                                                        (round to whole numbers).  The deduction must be allocated in the same proportion as income is allocated for income tax purposes.  The pass-through 
                                                                        entity qualifying for the deduction must provide a copy of this form to each partner, member or shareholder claiming the deduction, who must file the copy 
                                                                        with their return.  If you have more than fifteen partners, members or shareholders, please print an additional page(s).
                                                                                                                                  Last Four Digits of Social Security 
                                                                            Name of Partner, Member or Shareholder                           Number or Complete FEIN       Share %                   Deduction Amount

                                                                        Example: Joe Smith                                        XXX-XX-1234 or 12-3456789                50 %                    $ 500.00

                                                                        1.                                                                                                                       % $

                                                                        2.                                                                                                                       % $

                                                                        3.                                                                                                                       % $

                                                                        4.                                                                                                                       % $

                                                                        5.                                                                                                                       % $

                                                                        6.                                                                                                                       % $

                                                                        7.                                                                                                                       % $

                                                                        8.                                                                                                                       % $

                                                                        9.                                                                                                                       % $
                                    Allocation Instructions and Schedule
                                                                        10.                                                                                                                      % $

                                                                        11.                                                                                                                      % $

                                                                        12.                                                                                                                      % $

                                                                        13.                                                                                                                      % $

                                                                        14.                                                                                                                      % $

                                                                        15.                                                                                                                      % $

                                                                        Total Deduction:  Enter your total deduction here and on Form MO-1040, Line 18B. ................. 100 %                   $ 0.00

Schedule MO-NJD must be filed with Form MO-1040, MO-1120, or MO-1120S.  Please attach to the form and mail to the appropriate address as shown 
on page 1 of the form.
                                                                                                                                                                                                   Form MO-NJD (Revised 12-2014)
                                                                            Taxation Division                                                         
                                                                            Personal Tax                     Corporate Tax                    Phone: (573) 751-4541 
                                                                            P.O. Box 385                     P.O. Box 3365                    Fax: (573) 522-1721                                
                                                                            Jefferson City, MO 65105-0385  Jefferson City, MO 65105-3365 
                                                                            E-mail: income@dor.mo.gov        E-mail: corporate@dor.mo.gov 
                                                                            Visit http://smallbiztax.mo.gov/ for additional information.

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