Free CT-612 - New York

CT-612

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New York State Department of Taxation and Finance

Claim for Remediated Brownfield Credit For Real Property Taxes
Tax Law -- Sections 187(h), 210.34, 1456(r), and 1511(v)
All filers must enter tax period: beginning ending Employer identification number (EIN)

Name Address of qualified brownfield site

File this form with your franchise tax return. A separate Form CT-612 must be filed for each Certificate of Completion (COC). Enter the date of execution of the Brownfield Cleanup Agreement (BCA) for the brownfield site for which you are claiming this credit .............................................................................................. Schedule A -- Brownfield site identifying information Enter the following information as listed on the COC issued by the Department of Environmental Conservation (DEC) for the qualified site (see instructions). Attach a copy of the COC.
Site name Site location - municipality DEC region Site location - county Division of Environmental Remediation (DER) site number Date COC was issued

Mark an X in the box if you received notification from the Department of State that the qualified site is located in a Brownfield Opportunity Area ......................................................................................................................... If applicable, enter the date the COC was transferred pursuant to the transfer or sale of the qualified site. Attach a copy of the sale or transfer documentation to this form ............................ Is the qualified site for which the COC was issued by the DEC located entirely within an environmental zone (EN-Zone)? ....................................................................................................................
March 31 June 30 September 30 December 31

Yes
Total

No

Schedule B -- Computation of average number of full-time employees employed by a developer and a lessee

1 Average number of full-time employees (see instructions; if less than 25 no credit is allowed) ..................

1.

Schedule C -- Computation of remediated brownfield credit for real property taxes
2 3 4 5 6 7 8 9 10 11 Employment number factor (see instructions) ....................................................................................... Eligible real property taxes (see instructions) ......................................................................................... Enter 0.25 (if the qualified site is located entirely within an EN-Zone, enter 1.0) ........................................... Remediated brownfield credit for real property taxes (multiply line 2 by line 3 by line 4) ......................... Recapture of remediated brownfield credit for real property taxes (see instructions) ........................... Remediated brownfield credit for real property taxes after recapture (see instructions) ....................... Limitation of remediated brownfield credit for real property taxes (multiply 10,000 by line 1).................. Remediated brownfield credit for real property taxes after limitation (enter the lesser of line 7 or line 8) Remediated brownfield credit for real property taxes from partnerships ............................................ Total remediated brownfield credit for real property taxes (add lines 9 and 10; New York S corporations see instructions) ................................................................................................................................. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.

52001080094

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CT-612 (2008)

Schedule D -- Application of remediated brownfield credit for real property taxes (New York S corporations do not complete this section)
12 Enter your franchise tax (see instructions) .............................................................................................. 13 Tax credits claimed before the remediated brownfield credit for real property taxes (if you are applying multiple credits on your franchise return, see instructions)........................................................... 14 Subtract line 13 from line 12 ................................................................................................................. 15 Minimum tax (see instructions) ................................................................................................................ 16 Credit limitation (subtract line 15 from line 14; if zero or less, enter 0) ........................................................ 17 Remediated brownfield credit for real property taxes to be used this tax year (enter the lesser of line 11 or line 16; transfer this amount to your franchise tax return) ........................................................... 18 Unused remediated brownfield credit for real property taxes available for refund or as an overpayment (subtract line 17 from line 11) ......................................................................................... 19 Amount of unused credit on line 18 to be refunded ............................................................................ 20 Amount of unused, nonrefunded credit to be credited as an overpayment in the next tax year (subtract line 19 from line 18)............................................................................................................... 12. 13. 14. 15. 16. 17. 18. 19. 20.

Schedule E -- Partnership information (see instructions)
Name of partnership Partnership's EIN Amount of credit

52002080094