Free CT-613 - New York

CT-613

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New York State Department of Taxation and Finance

Claim for Environmental Remediation Insurance Credit
Tax Law -- Sections 23, 187, 210.35, 1456(s), and 1511(w)
All filers must enter tax period: beginning ending Employer identification number (EIN)

Name

File this form with your franchise tax return. Enter the date of execution of the Brownfield Cleanup Agreement (BCA) for the property for which you are claiming this credit ................................................................................................... Brownfield site identifying information Enter the following information as listed on the Certificate of Completion (COC) issued by the Department of Environmental Conservation (DEC) for the qualified site (see instructions). Attach a copy of the COC. Also attach a copy of the certification form for the environmental remediation insurance tax credit completed by the insurer.
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 .................................................................................................................. Computation of available environmental remediation insurance credit
1 2 3 4 5 6 7 8 9 10 11 12 Qualified environmental remediation insurance premiums paid ........................................................ Multiply line 1 by 50% (.5) .................................................................................................................... Enter line 2 amount or 30,000, whichever is less ................................................................................. Environmental remediation insurance credit received from a flow-through entity (see instructions) ..... Subtotal (add lines 3 and 4; New York S corporations, see instructions) ........................................................ Recapture of credit (see instructions) .................................................................................................... Total environmental remediation insurance credit available for use (see instructions) .......................... 1. 2. 3. 4. 5. 6. 7.

Computation of environmental remediation insurance credit limitation
Tax due before credits (see instructions) ................................................................................................ 8. Enter other credits claimed before the environmental remediation insurance credit (see instructions) ... 9. Net tax (subtract line 9 from line 8) ........................................................................................................... 10. Minimum tax (see instructions) ............................................................................................................... 11. Credit limitation (subtract line 11 from line 10; if line 11 is greater than line 10, enter 0) ............................... 12.

Computation of environmental remediation insurance credit used, refunded, or credited as an overpayment in the next tax year
13 Environmental remediation insurance credit to be used for the current tax year (enter the lesser of line 7 or line 12; transfer the result to your franchise tax return) ................................................................ 14 Environmental remediation insurance credit available for refund or as an overpayment (subtract line 13 from line 7) .............................................................................................................................. 15 Environmental remediation insurance credit to be refunded (limited to the amount on line 14) ............... 16 Environmental remediation insurance credit to be credited as an overpayment in the next tax year (subtract line 15 from line 14)............................................................................................................... 13. 14. 15. 16.

52101080094

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CT-613 (2008)

Partnership information (see instructions for line 4)
Name of partnership Partnership's EIN Amount of credit

52102080094