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                                        Missouri Department of Revenue                                 Department Use Only
                            Form        New Jobs Training Program                                      (MM/DD/YY)
 MO-JTC                                 Employers Withholding Form
                                                                                                                           Reporting Period
                                                                                                                           (MM/YY)

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

                             Name                                                                                          Project Name 

                             Owner Name                                                                                    Project Number

 Business                    City                                                     State Zip Code                       Phone Number                                         
                                                                                                                           (__ __ __) __ __ __ - __ __ __ __
Your completed  Employer’s  Return of Income Taxes Withheld  (                        Form MO-941) or proof of filing  for electronic  filers must accompany  this form. 
Form  MO-JTC  must  be  submitted  using  the  same  frequency  that  you  file  Form  MO-941.    Form  MO-JTC  and  all  required  attachments  must  be 
received by the 20th of the month in order to guarantee timely processing.   All figures on Form MO-JTC  must be rounded to the nearest dollar.  
Figures calculated below a dollar will be disregarded during processing.
 1.  Enter the total amount of gross wages paid to the first 100 qualifying persons employed in the New Jobs Training Program (NJTP) this period.   
                            (Please attach a wage listing—see “sample form” attached.)
  2.  The NJTP credit fixed percentage is 2.5% (.025)
  3.  Multiply amount entered on Line 1 by Line 2 to arrive at the total credit allowed on the first 100 qualifying employees.
  4.   Enter the total amount of gross wages paid to qualifying employees exceeding the first 100 employed in the NJTP this period.  (Please attach a 
                            wage listing—see “sample form” attached.)
  5.  The NJTP credit fixed percentage allowed is 1.5% (.015)
  6.   Multiply amount entered on Line 4 by Line 5 to arrive at the total credit allowed on the number of qualifying employees exceeding the first 100 
                            employed in the NJTP.
  7.  Add Line 3 to Line 6 and enter here.  This is your total credit amount.
  8.  Enter the total amount of withholding tax liability from line 1 of the Form MO-941 (Amount must match amount filed for tax period for credit to be approved).
  9.    Enter the total number of jobs (attach a list) reported for this withholding claim.
10.  Enter the average hourly wage of the jobs reported for this withholding claim.
                              1.  Gross wages this filing period attributable to New Jobs Training Program (NJTP)
                             on first 100 qualifying jobs .......................................................................................................  1         $

                              2.  NJTP credit percentage on first 100 qualifying jobs is 2.5% ...................................................  2                            .025
                              3.  NJTP credit for first 100 qualifying jobs (multiply Line 1 by Line 2).  ......................................  3                          $
                              4.  Gross wages attributable to NJTP qualifying jobs in excess of first 100 jobs,
                             if applicable.  ............................................................................................................................  4 $
                              5.  NJTP credit percentage over 100 qualifying jobs is 1.5%.  .....................................................  5                            .015
                              6.  NJTP credit in excess of first 100 qualifying jobs (multiply Line 4 by Line 5)..........................  6                                $
                              7.  Total NJTP credit amount (add Line 3 and Line 6). ................................................................  7                      $
 Calculate Amount of Credit   8.  Withholding Tax liability from Line 1 of Form MO-941.............................................................  8                       $

                              9.  Total number of jobs (on attached list) reported for this withholding claim.  ...........................  9 
                            10.  Average hourly wage of jobs reported on Line 9.  ...................................................................  10                    $ 

                             Under penalties of perjury, I declare that the above information and any attached supplement is true, complete, and correct.
                             Signature                                                      E-mail Address                                                                      

 Signature                   Printed Name                                                   Phone Number                               Date (MM/DD/YYYY)
                                                                                            (__ __ __) __ __ __ - __ __ __ __          __ __ /__ __ /__ __ __ __

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                                                              Forms MO-JTC and MO-RJC Required Wage Listing
                                                This is a “sample form” (based on the project’s application) to include the type of information 
                                                that is required to be attached to each Form MO-JTC or Form MO-RJC submitted to the Department.

Please provide a wage listing for the first 100 qualifying jobs indicated on Line 1 of your Form MO-JTC or Form MO-RJC.  The information 
needed is the occupational title, number of jobs, and the wage or salary paid per occupational title.  You will also need to total the amount 
of wages for the first 100 qualifying jobs.

                                                Job Title                     Number   Wage        Job Title                                     Number Wage
                                                                                       or Salary                                                        or Salary

                        First 100 Jobs

                                                Total Gross Wages for the First 100 Qualifying Jobs     ____________________ 
                                                The section below is used to provide a wage listing for the qualifying jobs exceeding the first 100. This is indicated on Line 4 of 
                                                your Form MO-JTC or Form MO-RJC. The instructions for completing this form are the same as above.
                                                Job Title                     Number   Wage        Job Title                                     Number Wage
                                                                                       or Salary                                                        or Salary

                        Jobs Exceeding First 100

                                                Total Gross Wages for the Qualifying Jobs in Excess of the First 100     _____________________

                                                                                                                                                 Form MO-JTC (Revised 12-2014)
Mail to:  Taxation Division                                                   Phone: (573) 751-5759
                                                P.O. Box 3375                 TTY: (800) 735-2966  Visit http://dor.mo.gov/taxcredit/
                                                Jefferson City, MO 65105-3375 Fax: (573) 522-6816  for additional information.
                                                                              E-mail:  withholdingproject@dor.mo.gov  

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