Enlarge image | Application for West Virginia Manufacturing Investment Tax Credit MITC-A REV 3-15 for Investments Placed in Service On or After January 1, 2003 Name Identification Number Business Name Tax Year _______________, ____________ to _______________, ____________ Street Address City, Town, or Post Office State Zip Code Application is hereby made to the Tax Commissioner of West Virginia for allowance of Manufacturing Investment Tax Credit with respect to qualified manufacturing investment property placed in service or use during Applicant’s tax year ending: / / MM DD YYYY **Manufacturers must complete items 1 through 5 and the certification. Businesses whose primary NAICS code is 211112 must complete items 1 through 6 and the certification.** 1. Investment Purpose (Check only 1) Industrial Expansion Industrial Revitalization Both Industrial Expansion and Revitalization 2. Business Activity in West Virginia: a) North American Industry Classification System Code (NAICS): ___________________________________ b) Narrative Description of Business Activity in West Virginia: 3a. Investment Total Investment Qualified Investment Year________________________ Amount $___________________ $___________________________ 3b. Location(s) of Investment in West Virginia _________________________________________________________ 3c. General Description of Qualified Investment (Narrative): Schedule MITC-A Page 1 of 2 REV. 3-15 |
Enlarge image | 4. Employment: Payroll Jobs a) Total WV payroll and number of jobs prior to investment: b) Total WV payroll and number of jobs this year: 5. Benefits: a) Percentage of employes covered under health plans: % b) Average annual health plan benefit costs per employee: c) Percentage of employees covered under retirement plan: % d) Average annual retirement benefit cost per employee: **Businesses whose primary NAICS Code is 211112 6. In application for the Manufacturing Investment Tax Credit, it is affirmed that the applicant is in compliance with the additional Manufacturing Investment Tax Credit requirements for businesses whose primary North American Industry Classification System (NAICS) Code is 211112 (The additional requirements are prescribed in WV Code §11-13S-4(e) and are enumerated in the instructions). Affirmation: In compliance Not in compliance Under penalties of perjury, I declare that I have examined this credit claim form (including accompanying schedules and statements) and to the best of my knowledge it is true and complete. Signature of Taxpayer Name of Taxpayer (type or print) Title Date Person to contact concerning this return Telephone Number Signature of Preparer other than Taxpayer Address Date Please return the completed application to: West Virginia State Tax Department PO Box 2991 Charleston, WV 25330-2991 If you have any questions or need further information regarding this application, telephone (304) 558-3333 or toll free to 1-800-WVA-TAXS (1-800-982-8297) Schedule MITC-A Page 2 of 2 REV. 3-15 |
Enlarge image | APPLICATION FOR WEST VIRGINIA MANUFACTURING INVESTMENT TAX CREDIT FOR INVESTMENTS PLACED IN SERVICE ON OR AFTER JANUARY 1, 2003 Information and Instructions HE Manufacturing Investment Tax Credit (MITC) investment. (Check only one block.) is available to a manufacturer making a qualifi ed investment (on or after January 1, 2003) for a. The Taxpayer for purposes of industrial expansion purposes of industrial expansion or revitalization places qualifi ed investment property in service or use. Tof an industrial facility within West Virginia. Qualifi ed b. The Taxpayer for purposes of industrial revitalization businesses include only those engaged in the activity of places qualifi ed investment property in service or use. manufacturing within West Virginia. Manufacturing is defi ned as any business activity classifi ed as having a c. The Taxpayer for purposes of both industrial expansion sector identifi er, consisting of the fi rst two digits of the six- and revitalization places qualifi ed property in service digit North American Industry Classifi cation System code or use. number, of thirty-one, thirty-two or thirty-three or the six digit North American Industry Classifi cation System Code tttttteeeeeem m m m m m IIIIII Business Activity in West Virginia: Number 211112. 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 The Manufacturing Investment Tax Credit is not available a. Enter the North American Industry Classifi cation to businesses engaged in the activity of electric power System Code that most closely describes your business generation. Qualifi ed investment by businesses engaged activity in West Virginia. in the activity of electric power generation qualify for another investment tax credit, the Industrial Expansion and b. Describe the industrial expansion or industrial Revitalization Credit. revitalization activity in West Virginia that is associated Industrial expansion is defi ned as capital investment in a with your new investment (e.g., construction of a new new or expanded industrial facility in this State. Industrial reconstituted wood product manufacturing plant). revitalization or revitalization is defi ned as capital mmmmmm investment in an industrial facility located in this State to ttttttIIIIIIeeeeee Investment: Enter the year investment is placed 3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a3a replace or modernize buildings, equipment, machinery and into service or use in the fi rst column, the total other tangible personal property used in connection with dollar amount of investment placed into service or use the operation of the facility in an industrial business of the in the second column and the dollar amount of qualifi ed Taxpayer, including the acquisition of any real property investment placed into service or use in the third column. necessary to the industrial revitalization. Industrial business Qualifi ed Investment is determined according to the or industrial Taxpayer is defi ned as any Taxpayer who is following useful life (straight line depreciation): primarily engaged in a manufacturing business. Useful Life By Law, no credit may be allowed or applied for any qualifi ed At Least But Less Than Percent Qualifi ed investment property placed in service until the person 0 — 4 years 0 asserting a claim for the credit makes writt en application 4 — 6 years 33-1/3 to the Tax Commissioner. Failure to timely apply for credit will result in forfeiture of 50% of the annual credit allowance 6 — 8 years 66-2/3 otherwise available under this requirement. Form MITC-A 8 or more years 100 is designed to be a general application form for taxpayers m m m m m m wishing to claim credit based upon investments placed into ttttttIIIIIIeeeeee Enter the location(s) of the qualifi ed investment 3b3b3b3b3b3b3b3b3b3b3b3b3b3b3b3b3b3b3b3b3b3b3b3b3b3b3b3b3b3b use or service on or after January 1, 2003. The timely fi ling property (i.e. Main Street, Weston, or 12 miles north of this application is a condition precedent to claiming tax of Pipestem at the Intersection of State Route 3 and State credits. This application must be fi led annually no later Route 20). than the due date of the taxpayer’s West Virginia income m m m m m m tax return including any legally granted extension of time ttttttIIIIIIeeeeee Provide a general description of the qualifi ed for fi ling such returns. 3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c3c investment property in the space provided (i.e. $100,000 to be invested in buildings, $500,000 to be invested in machinery and equipment, etc.) mmmmmm INSTRUCTIONS T OFORM MITC-A ttttttIIIIIIeeeeee Investment Purpose: Place a check mark in the 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 block next to the applicable purpose of your MITC-A Rev. 3-15 Page 1 |
Enlarge image | ttttttIIIIIIeeeeeem m m m m m Employment: employees for said construction from the local labor 4 4 4 4 4 4 4 4 4 4 4 4 market, to be rounded off , with at least two employees a. Enter your total West Virginia payroll and number from outside the local labor market permissible for each of jobs att ributed to that payroll for the prior year (i.e., employer per project, “the local labor market” being twelve-month period) before the placement of this defi ned as every county in West Virginia and any count year’s qualifi ed investment subject to Manufacturing outside of West Virginia if any portion of that county is Investment Tax Credit into service or use. within fi fty miles of the border of West Virginia. b. Enter your total West Virginia payroll and number of (2) Any person or entity unable to employ the minimum jobs for the current year. number of employees from the local labor market shall ttttttIIIIIIeeeeeem m m m m m inform the nearest offi ce of the bureau of employment Benefi ts: programs’ division of employment services of the 5 5 5 5 5 5 5 5 5 5 5 5 number of qualifi ed employees needed and provide a a. Enter the percentage of your employees covered job description of the positions to be fi lled. under your sponsored health insurance plan. (3) If, within three business days following the placing of b. Enter the average annual cost of your employer- a job order, the division is unable to refer any qualifi ed provided health insurance benefi ts (i.e., benefi t costs job applicants to the person or entity engaged in said divided by number of covered employees). construction or refers less qualifi ed job applicants than the number requested, then the division shall c. Enter the percentage of your employees covered under issue a waiver to the person or entity engaged in said your retirement plan. construction to fi ll any positions covered by the waiver from outside the local labor market. The waiver shall be d. Enter the average annual retirement benefi t either oral or in writing and shall be issued within the contribution cost per covered employee. prescribed three days. A waiver certifi cate shall be sent ttttttIIIIIIeeeeeemmmmmm to the person or entity engaged in said construction for Additional Requirements for businesses Whose its permanent project records. 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 Primary NAICS Code is 211112. The timely fi ling of this application coincides with Check the appropriate box to affi rm compliance with the the authorization for the Applicant to begin claiming provisions of WV Code §11-13S-4(e). That section of the Manufacturing Investment Tax Credit benefi ts. Such fi ling code is copied below: of the application will not bar or otherwise prevent the Tax WV Code §11-13S-4(e) Commissioner from auditing or examining Applicant’s books and records for compliance with the Manufacturing (1) Any person or entity undertaking any construction Investment Tax Credit law and regulations. related to any business activity included within North American Industrial Code six digit number 211112, the This application must be signed by an offi cer of the value of which is an amount equal to or greater than company to be valid. $500,000, shall hire at least seventy-fi ve percent of MITC-A Rev. 3-15 Page 2 |