"Application for Final Certification - Maryland Job Creation Tax Credit" - Maryland

Application for Final Certification - Maryland Job Creation Tax Credit is a legal document that was released by the Maryland Department of Commerce - a government authority operating within Maryland.

Form Details:

  • Released on March 1, 2018;
  • The latest edition currently provided by the Maryland Department of Commerce;
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Maryland Job Creation Tax Credit
Application for Final Certification
Page 1 of 3
Informati
Applicant
on:
1) Business Name:
2) Business Address: _____________________________________________________________________
_____________________________________________________________________
3) FEIN:
4) UI Number:
5) Type of Entity (Corp, LLC, S-Corp, etc.):
6) Business NAICS Code:
7) Beginning and End of Tax Year:
8) Total number of full-time employees at the time of application:
9) Total number of full-time employees in Maryland at the time of application:
10) Total number of years in business:
11) Total number of years in business in Maryland:
tio
Facility Informa
n:
12) Facility Address: ______________________________________________________________________
______________________________________________________________________
13) County:
14) Facility NAICS Code:
15) PFA Designation:
State Enterprise Zone
Federal Empowerment Zone
Inside the I-495 or I695 Beltway
Sustainable Community
Incorporated Municipality
County Designated Growth Area
16) Which best describes the project:
New Establishment
Expansion
Relocation
March 2018
Maryland Job Creation Tax Credit
Application for Final Certification
Page 1 of 3
Informati
Applicant
on:
1) Business Name:
2) Business Address: _____________________________________________________________________
_____________________________________________________________________
3) FEIN:
4) UI Number:
5) Type of Entity (Corp, LLC, S-Corp, etc.):
6) Business NAICS Code:
7) Beginning and End of Tax Year:
8) Total number of full-time employees at the time of application:
9) Total number of full-time employees in Maryland at the time of application:
10) Total number of years in business:
11) Total number of years in business in Maryland:
tio
Facility Informa
n:
12) Facility Address: ______________________________________________________________________
______________________________________________________________________
13) County:
14) Facility NAICS Code:
15) PFA Designation:
State Enterprise Zone
Federal Empowerment Zone
Inside the I-495 or I695 Beltway
Sustainable Community
Incorporated Municipality
County Designated Growth Area
16) Which best describes the project:
New Establishment
Expansion
Relocation
March 2018
Page 2 of 3
Eligibility Requirements – Project & Business Activities
17) Intent Date:
18) Effective Date of Start-up or Expansion:
19) Type of activity business is “primarily engaged in” at the business facility (check all apply)
Biotechnology
Manufacturing
Forestry/Fishing
Mining
Research
Central Financial Services
Transportation
Development
Central Real Estate Services
Communications
Testing
Central Insurance Services
Public Utility
Computer Related Services
Company Headquarters
Warehousing/Distribution
Computer Programming
Central Administrative Services
Agriculture
Data Processing
Business Services (JCTC-PFA)
Operations of entertainment, recreation, cultural or tourism related activities in a multiuse facility
located within a revitalization area, if the facility generates a minimum of 1,000 new full-time
equivalent filled positions in a 24-month period.
20) Description of activities performed and product produced at the facility: ________________________
_____________________________________________________________________________________
Eligibility Requirements – Qualified Jobs and Wage
21) Verify all jobs claimed below were hired after the intent date:
YES
NO
22) Actual Jobs and Wage
Total
Year Job Created
Qualified Positions
per Year
Aggregate
Annual Wages ($)
23) All new qualified positions pay at least 120% of Maryland State Minimum Wage:
YES
NO
24) All new qualified positions have been filled for at least 12 months:
YES
NO
25) Provide the required information on each "qualified position" that the business wants to claim: using
"Qualified Employees' List" attached to this application and available to download from our
website:
http://commerce.maryland.gov/fund/programs-for-businesses/job-creation-tax-credit
March 2018
Page 3 of 3
Signature of Business Owner/Officer and Contact Information:
The form must be signed by an owner or officer of the business entity.
Collection of Personal Information: In accordance with Executive Order 01.01.1983.18, the Department of Commerce
(“Commerce”) advises you as follows: Certain personal information requested by the Department is necessary in
determining your eligibility. Failure to disclose this information may result in the denial of one of these benefits or
services. Availability of this information for public inspection is governed by the provisions of the Maryland Public
Information Act, General Provisions Article, Sections 4-101 et seq. of the Annotated Code of Maryland. This information
will be disclosed to appropriate staff of the Department and other public officials for purposes directly connected with
administration of the program for which its use is intended. Such information is routinely shared with State, federal or
local government agencies. You have the right to inspect, amend or correct personal records in accordance with the
Maryland Public Information Act.
Publicity: The applicant agrees that Commerce may issue press releases and otherwise publicize information about the
applicant’s employment levels before and after its qualification for the Job Creation Tax Credit.
Employment and Wage Data: Periodically the Office of Labor Market Analysis and Information of the Maryland
Department of Labor, Licensing and Regulation (“DLLR”), in cooperation with the U. S. Department of Labor, Bureau of
Labor Statistics (“BLS”), collects employment and wage data from you and other employers who conduct business in the
State of Maryland. This information, collected on the Multiple Worksite Report (BLS 3020) and the Annual Refiling Survey
(BLS 3023), is kept confidential and may only be used by Commerce with your written consent. Commerce is requesting
disclosure of this information in order to evaluate the effectiveness of Commerce’s economic development programs and
their impact on your company’s employment level.
Consent: I give consent to DLLR to release the information that our company provides on the BLS 3023 form and the BLS
3020 form to Commerce, solely for the purpose of evaluating the effectiveness of Commerce’s economic development
programs and their impact on our company’s employment level.
Verification: Under penalties of perjury, I declare that the information contained in this application, to the best of my
knowledge and belief, it is true, correct and complete.
Date
Signature of Owner/Officer of Company
Print Owner/Officer’s Name
Title of Officer
Contact Name:
Contact Phone Number:
Contact Email:
Please return this application form to:
Mark A. Vulcan
Program Manager, Tax Incentives
Maryland Job Creation Tax Credit Program
Maryland Department of Commerce
401 East Pratt Street, 17
th
Floor
Baltimore, Maryland 21202
March 2018
Maryland Job Creation Tax Credit Instructions
for Final Application
Below are instructions for filling out the Maryland Job Creation Tax Credit (JCTC) Final Application. The
instructions are guidelines. You may download the JCTC statute and regulations from the Maryland
Department of Commerce’s (Commerce) website at:
http://commerce.maryland.gov/fund/programs-for-
businesses/job-creation-tax-credit
Applicant Information:
1) Provide the full legal name of the entity as it should appear on the certificate. If Maryland law requires the
business entity to register with the State Department of Assessments and Taxation (SDAT), this name must
be registered as a business entity in good standing. You may check the status of your business entity at:
https://egov.maryland.gov/businessexpress/entitysearch
2) Provide the address of the business entity. This is the address the certificate will be mailed to unless
otherwise noted on the application.
3) Provide the Federal Employee ID Number (FEIN).
4) Provide the unemployment insurance number (UI).
5) Provide the type of business entity, i.e. Corporation, Limited Liability Corporation, Sole Proprietorship.
6) Provide the North American Industrial Classification Code (NAICS) of the business entity. More
information on NAICS codes can be found at:
http://www.census.gov/epcd/www/naicstab.htm
7) Provide the beginning and end date of the Tax Year for which the applicant is applying for credits.
8) Provide the total number of full-time employees at the time of this application.
9) Provide the total number of full-time employees in Maryland at the time of this application.
10) Provide the total number of years in business.
11) Provide the total number of years in business in Maryland.
Facility Information:
12) Provide the address of the facility that has created the new positions. The expansion or establishment of a
business must be at a single location in the state. A single business entity may have more than one eligible
location, provided that each is certified and meets the requirements of the statute.
13) Provide the County where the facility is located.
14) Provide NAICS for the facility. More information on NAICS codes can be found at:
http://www.census.gov/epcd/www/naicstab.htm
15) If you are located in one or more Priority Funding Area (PFA), please check all areas that apply. If you are
unsure whether your facility is in a PFA, contact Stacy Kubofcik at 410-767-4980 or Emiko Kawagoshi at
410-767-4041.
16) Check the best description of your project – New Establishment, Expansion or Relocation.
Eligibility Requirements – Project & Business Activities
17) Provide the date that the business declared its intent to claim the JCTC. If you are not sure the intent date,
contact Stacy Kubofcik at 410-767-4980 or Emiko Kawagoshi at 410-767-4041.
18) Provide the effective date of the start-up or expansion. This is the date that the business begins creating
new qualified positions.
March 2018
19) To qualify, a business must be primarily engaged in a qualified activity at the facility. This means that at
least 51 percent of its business must be in one or more of the activities listed. Check all activities that
apply. A business entity that is primarily engaged in business services must be located in a PFA to qualify.
20) Provide a written description of the activities performed and products produced at the facility.
Eligibility Requirements – Qualified Jobs and Wages
21) Verify that all jobs claimed in the chart in Section 22 were hired after the intent date. A business may only
count new qualified positions created after the intent date.
22) Provide the number of “new qualified positions” created by the business at the facility, the annual wages
of those positions, and the year in which they were created. A qualified position is a full-time position
paying at least 120 percent of the prevailing State minimum wage. The business entity must create a
minimum number of qualified positions within any 24-month period (after the intent date). The minimums
are: a) 60 new qualified positions; b) 25 new qualified positions in a PFA; c) 10 jobs in counties with annual
average employment less than 75,000 or median household income less than two-thirds of the statewide
median household income (For the current list of eligible counties, please contact Stacy Kubofcik at 410-
767-4980 or Emiko Kawagoshi at 410-767-4041).
23) Verify that all new qualified positions pay at least 120 percent of the prevailing State minimum wage.
State Minimum Wage is $9.25/hr as of July1, 2017, and will increase to $10.10/hr on July 1, 2018.
Businesses will have to pay at least $11.10/hr after July 1, 2017 and $12.12/hr after July 1, 2018.
24) Verify that all new qualified positions have been filled for at least 12 months.
25)
Provide the following information for each employee that the business wants to claim: employee’s name,
start date, termination date, annual salary, and last 4 digits of SSN by using “Qualified Employees’ List”
http://commerce.maryland.gov/fund/programs-for-businesses/job-
available from Commerce website:
creation-tax-credit. If the qualified new employee was terminated, but the position has been backfilled by
another new qualified employee, please provide the backfilled employee’s information. Commerce take
data security seriously and protecting your data is a core priority. We recommend that you secure
electric documents sent through email with a password.
Signature of Business Owner/Officer and Contact Information:
This application form must be signed by a business owner or the officer of the business. Please also provide
contact information.
If you have any questions about the Maryland Job Creation Tax Credit Application for Final Certification, please
contact Stacy Kubofcik at 410-767-4980 or Emiko Kawagoshi at 410-767-4041.
March 2018
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