Free CT-41 - New York

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CT-41
Name

New York State Department of Taxation and Finance

Claim for Credit for Employment of Persons with Disabilities
Tax Law -- Articles 9, 9-A, 32, and 33
beginning

All filers must enter tax period: ending

Employer identification number

File this with Form CT-3, CT-3-A, CT-3-S, CT-32, CT-32-A, CT-32-S, CT-33, CT-33-A, CT-33-NL, CT-183, CT-184, CT-185, or CT-186.

Schedule A -- Computation of credit (see Form CT41I, Instructions for Form CT-41)
Part 1 -- Computation of credit on qualified first-year wages (do not include employees shown in Part 2 below)
A Name of qualified employee (attach additional sheets if necessary) B Social security number of qualified employee C D One-year period for qualified Wages paid during tax year first-year wages for services rendered during (enter beginning and end dates) one-year period shown in column C ($6,000 limit)

1 2 3

Total (add amounts in column D and amounts from attached sheets, if any) ................................................... Tax credit percentage (35%) ............................................................................................................... Tax credit on qualified first-year wages (multiply line 1 by line 2) ..........................................................

1. 2. 3.

.35

Part 2 -- Computation of credit on qualified second-year wages (do not include employees shown in Part 1 above)
A Name of qualified employee (attach additional sheets if necessary) B Social security number of qualified employee C D One-year period for qualified Wages paid during tax year second-year wages for services rendered during (enter beginning and end dates) one-year period shown in column C ($6,000 limit)

4 5 6 7 8 9

Total (add amounts in column D and amounts from attached sheets, if any) .................................................. Tax credit percentage (35%) ............................................................................................................... Tax credit on qualified second-year wages (multiply line 4 by line 5) .................................................... Total credit on qualified first-year and second-year wages (add lines 3 and 6) .................................... Credit from partnerships (see instructions) .......................................................................................... Total credit (add lines 7 and 8) .............................................................................................................

4. 5. 6. 7. 8. 9.

.35

Schedule B -- Computation of credit used and carried forward
(New York S corporations: do not complete Schedule B; see instructions.)
10 11 12 13 14 15 16 Unused credit carried forward from preceding tax year (see instructions) ........................................... Total credit computed for the current tax year (enter amount from line 9) ............................................. Total credit (add lines 10 and 11) ......................................................................................................... Tax before credits (see instructions) ...................................................................................................... Enter other tax credits claimed before this credit (see instructions) .................................................... Net tax (subtract line 14 from line 13) ...................................................................................................... Tax limitation -- enter appropriate tax: Section 183 -- enter minimum tax of 75 Section 185 -- enter minimum tax of 10 Section 186 -- enter minimum tax of 125 Article 9-A -- enter the fixed dollar minimum tax Articles 32 or 33 -- enter minimum tax of 250 Article 33 combined filers -- enter combined minimum tax for subsidiaries ................................. 17 Tax credit limitation (subtract line 16 from line 15; if line 16 is greater than line 15, enter 0) ........................ 18 Tax credit used for the current tax year (enter line 12 or line 17 amount, whichever is less) ..................... 19 Tax credit carried forward (subtract line 18 from line 12) ....................................................................... 10. 11. 12. 13. 14. 15.

16. 17. 18. 19.

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