Form L1L2 "Nebraska Advantage Rural Development Act Application" - Nebraska

What Is Form L1L2?

This is a legal form that was released by the Nebraska Department of Revenue - a government authority operating within Nebraska. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2015;
  • The latest edition provided by the Nebraska Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form L1L2 by clicking the link below or browse more documents and templates provided by the Nebraska Department of Revenue.

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Download Form L1L2 "Nebraska Advantage Rural Development Act Application" - Nebraska

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Nebraska Advantage
L1L2
Rural Development Act Application
Name and Location Address
Name and Mailing Address
Legal Name of Applicant
Name
Street Address (Do not use P.O. Box)
Street or Other Mailing Address
City
State
Zip Code
City
State
Zip Code
For Revenue Use Only
Complete
Incomplete
1 A
Attach check for $500 application fee.
1A
B
1B
Employee Verification
a
Is the taxpayer registered for E-Verify, the federal electronic verification program
used to confirm whether employees are authorized to work in the United States?
YES
NO
b
If YES, do you agree to timely use E-Verify for employees hired in Nebraska after
the date of application?
YES
NO
c
If the answer to question 1B(a) or 1B(b) is NO, do not complete the rest of the
application, because you are not eligible to apply for this Nebraska tax incentive program.
d
Print out the “Company Information” page from the E-Verify program and include it as an attachment.
2 Exact name of applicant and any other entities, including disregarded entities, that are part of the project
A
2A
Entity Name
Entity Type
FEIN
NE Income Tax ID No.
1
2
3
4
(If you need more room, attach a schedule.)
B
If each entity in 2A is not included on the Affiliations Schedule, Form 851 (attached as part of
2B
item 8) provide an explanation of how the entities are related to each other.
C
What is the applicant’s tax year end?_____________If this does not agree with the copy of the tax return
2C
provided in item 8 below, provide an explanation.
3 Describe the applicant’s business
A
Narrative
3A
B
3B
Federal Principal Business Activity Code ________________________________________________
Federal Business Activity Title ________________________________________________________
C
Qualifying Business Activity (check the applicable boxes for the project):
3C
Assembling, fabricating, manufacturing, or processing of tangible personal property
Storing, warehousing, or distributing tangible personal property
Transportating tangible personal property
Conducting research, development, or testing for scientific, agricultural, animal husbandry,
food product, or industrial purposes
Livestock Production
Performing data processing services
Performing telecommunication services
Performing insurance services
Performing financial services (check applicable box below):
Financial institution subject to tax under Chapter 77, Article 38
Licensed by the Department of Banking and Finance
Licensed by the Securities and Exchange Commission
Administrative management of any activities, including the headquarter facilities relating to these
activities (provide a list which includes the name and accounting code for each of the
qualifying departments)
Selling tangible personal property (enter the percentage of total sales in the base year
represented by the following categories):
Sales at wholesale
Sales of tangible personal property assembled, manufactured, or processed
by the applicant
Sales of tangible personal property to a purchaser in one of the above-listed activities
8-610-2005 Rev. 12-2015 Supersedes 8-610-2005 Rev. 1-2015
RESET
PRINT
Nebraska Advantage
L1L2
Rural Development Act Application
Name and Location Address
Name and Mailing Address
Legal Name of Applicant
Name
Street Address (Do not use P.O. Box)
Street or Other Mailing Address
City
State
Zip Code
City
State
Zip Code
For Revenue Use Only
Complete
Incomplete
1 A
Attach check for $500 application fee.
1A
B
1B
Employee Verification
a
Is the taxpayer registered for E-Verify, the federal electronic verification program
used to confirm whether employees are authorized to work in the United States?
YES
NO
b
If YES, do you agree to timely use E-Verify for employees hired in Nebraska after
the date of application?
YES
NO
c
If the answer to question 1B(a) or 1B(b) is NO, do not complete the rest of the
application, because you are not eligible to apply for this Nebraska tax incentive program.
d
Print out the “Company Information” page from the E-Verify program and include it as an attachment.
2 Exact name of applicant and any other entities, including disregarded entities, that are part of the project
A
2A
Entity Name
Entity Type
FEIN
NE Income Tax ID No.
1
2
3
4
(If you need more room, attach a schedule.)
B
If each entity in 2A is not included on the Affiliations Schedule, Form 851 (attached as part of
2B
item 8) provide an explanation of how the entities are related to each other.
C
What is the applicant’s tax year end?_____________If this does not agree with the copy of the tax return
2C
provided in item 8 below, provide an explanation.
3 Describe the applicant’s business
A
Narrative
3A
B
3B
Federal Principal Business Activity Code ________________________________________________
Federal Business Activity Title ________________________________________________________
C
Qualifying Business Activity (check the applicable boxes for the project):
3C
Assembling, fabricating, manufacturing, or processing of tangible personal property
Storing, warehousing, or distributing tangible personal property
Transportating tangible personal property
Conducting research, development, or testing for scientific, agricultural, animal husbandry,
food product, or industrial purposes
Livestock Production
Performing data processing services
Performing telecommunication services
Performing insurance services
Performing financial services (check applicable box below):
Financial institution subject to tax under Chapter 77, Article 38
Licensed by the Department of Banking and Finance
Licensed by the Securities and Exchange Commission
Administrative management of any activities, including the headquarter facilities relating to these
activities (provide a list which includes the name and accounting code for each of the
qualifying departments)
Selling tangible personal property (enter the percentage of total sales in the base year
represented by the following categories):
Sales at wholesale
Sales of tangible personal property assembled, manufactured, or processed
by the applicant
Sales of tangible personal property to a purchaser in one of the above-listed activities
8-610-2005 Rev. 12-2015 Supersedes 8-610-2005 Rev. 1-2015
Application (continued)
For Revenue Use Only
Complete
Incomplete
4 Project definition
A
Project locations
4A
Complete the Column Required For Eligibility
Address (Street, City)
County
Village
City of 2nd Class
Census Tract #
1
2
3
4
B
4B
Explanation of how the applicant intends to satisfy the chosen levels
C
4C
Does this project include teleworkers working from their residences? ...................
YES
NO
Do the teleworkers reside in a county that meets the population requirement
of the selected level? .............................................................................................
YES
NO
D
4D
Expected Benefits (see
Calculation
Tips)
Attach a copy of completed Worksheets I and II, provided in the Calculation Tips. The total
estimated credits cannot exceed $1,000,000.
(1) Investment
a
Expected investment increase _____________________
b
Expected investment credits _______________________
(2) Employment
a
Expected full-time equivalent growth ________________
b
Expected employment credits ______________________
If items 5, 6, 7, or 8 are not available, indicate why each requested document is not available.
If a reorganization occurred since the previous tax year, provide copies of the documents for the previous
entities and a written explanation.
5 Attach a copy of most recent audited financial statements, including opinion letter.
5
Check this box if audited statements are not available and attach unaudited financial statements.
6 Enclose a copy of most recent federal income tax filing. Include a copy of first 5 pages, schedules supporting
6
the first 5 pages, Affiliations Schedule (Form 851), and a copy of each Shareholder’s Share of Income Credits,
Deductions, etc. (Schedule K-1). If the applicant is a sole proprietorship, provide a copy of the Profit
or Loss from Business (Schedule C) or the Profit or Loss from Farming (Schedule F).
7 Enclose a copy of most recent Nebraska income tax return.
7
Are all entities listed in item 2 on page 1 included in one unitary NE tax return?
YES
NO
If No, explain why:
Explain any difference between taxable income per the federal return and the amount reported
to Nebraska:
8 Enclose a copy of most recent Nebraska Reconciliation of Income Tax Withheld, Form W-3N.
8
9 Enter the Nebraska sales and use tax number for each entity listed in item 2 on page 1 (if not licensed,
9
attach a copy of the Nebraska Tax Application, Form 20, and proof of the date submitted):
Entity Name
Sales/Use Tax ID Number
1
2
3
4
(If you need more space, attach a schedule.)
Email. If you allow the Department to contact you by email, you accept any risk of loss of confidentiality associated with this method of communication.
Authorized Signature. This application must be signed by the owner/taxpayer, partner, member, corporate officer, or other individual authorized to
sign by a power of attorney on file with the Department.
sign
here
Authorized Signature
Phone Number
Please print your name
Title (See Instructions)
Email Address
Street or Other Mailing Address
City, State, Zip Code
Mail this application and payment (checks payable to “Nebraska Department of Revenue”) to:
Nebraska Department of Revenue, 301 Centennial Mall South, PO Box 98944, Lincoln NE 68509-8944.
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