Form Dtf 619 – Fill Out and Use This PDF

New York State Department of Taxation and Finance

DTF-619 Claim for QETC Facilities, Operations, and Training Credit

Tax Law — Articles 9-A and 22

File this form with corporate franchise tax return Form CT-3, CT-3-A, or CT-3-S or with personal income tax return Form IT-201, IT-203, IT-204, or IT-205. (See instructions, Form DTF-619-I, for assistance.)

Mark an X in the box for the tax year for which you are claiming the qualiied emerging technology company (QETC) facilities, operations,

and training credit on this form: 1st

2nd

3rd

4th

or (only if relocating from incubator facility) 5th

Line A — Partner in a partnership, S corporation shareholder, or beneiciary of an estate or trust.

Schedule A — QETC eligibility requirements (All the questions in Schedule A pertain to the tax year for which you are claiming the credit.)

Part 1 — Location and sales (Mark an X in the appropriate boxes.)

1	Is the company located in New York State?	Yes		No
2	Are the total annual product sales of the company $10,000,000 or less?	Yes		No
	If you answered Yes to questions 1 and 2, continue with Part 2.
	If you answered No to either question 1 or 2, stop. You cannot claim this credit for the current tax year.

Part 2 — QETC business activities

If Yes, enter in the box below a description of the company’s emerging technology products or services, and continue with line 4.

6191110094

	Please file this original scannable
61901110094	form with the Tax Department.

Page 2 of 4 DTF-619 (2011)

Schedule B — Credit eligibility requirements

Part 1 — Employment

12	Number of full-time employees employed in New York State and elsewhere during the tax year (see instr.)	.......	12.
13	Is the number of employees on line 12 one hundred (100) or less?	Yes			No
	If Yes, continue with line 14.
	If No, stop. You are not eligible to claim this credit.
14	Number of employees on line 12 who are employed in New York State		14.

Part 2 — Research and development activities

Part 3 — Gross revenues

Schedule C — Computation of credit component amounts

Part 1 — Research and development property credit component

Totals from attached schedule, if needed ...............................................................

22 Research and development property credit component amount ( add column D amounts )

22.

6192110094

	Please file this original scannable
61902110094	form with the Tax Department.

DTF-619 (2011) Page 3 of 4

Schedule C (continued)

Part 2 — Qualified research expenses credit component

A	B	C	D
Description of	Date paid or	Cost	Credit
expense	incurred		( column C × 9% ( .09 ))
	( mm-dd-yyyy )

Totals from attached schedule, if needed ..............................................................

25	Qualiied research expenses credit component amount ( add column D amounts )	25.
26	Beneficiary: Enter your share of the estate’s or trust’s qualiied research expenses credit
	component	26.
27	Total qualiied research expenses credit component ( add lines 25 and 26 )	27.

Fiduciaries: Include the line 27 amount on the Total line of Schedule D, column D, and continue with Part 3.

All others: Continue with Part 3.

Part 3 — Qualified high-technology training expenditures credit component

A	B	C	D	E	F
Employee name	Social security	Description of qualiied	Date paid or	Amount of	Credit ( enter the
	number	high-technology	incurred	expense	lesser of column E
		training expense	( mm-dd-yyyy )		or $4,000 )

Total from attached schedule, if needed............................................................................................................

28 Qualiied high-technology training expenditures credit component amount ( add column F amounts )... 28.

29Beneficiary: Enter your share of the estate’s or trust’s qualiied high-technology training

	expenditures credit component	29.
30	Total qualiied high-technology training expenditures credit component ( add lines 28 and 29 )	30.
	Fiduciaries: Include the line 30 amount on the Total line of Schedule D, column E, and
	continue with line 31.
	All others: Continue with line 31.
31	Total credit component amount ( add lines 24, 27, and 30 )
		31.
	Fiduciaries: Complete Schedule D.
	All others: Enter the line 31 amount on line 32.

6193110094

	Please file this original scannable
61903110094	form with the Tax Department.

Page 4 of 4 DTF-619 (2011)

Schedule D — Beneficiary’s and fiduciary’s share of credit

A	B	C	D	E	F
Beneiciary’s name	Identifying	Share of research	Share of qualiied	Share of qualiied	Total credit
( same as Form IT-205,	number	and development	research expenses	high-technology	( add columns C, D, and E )
Schedule C )		property	credit component	training expenditures
		credit component		credit component

Total

Totals from attached schedule, if needed

Fiduciary

Schedule E — Credit limitation

32 Total credit component amounts

32.

Schedule F — Application of the QETC facilities, operations, and training credit (Article 9-A only)

37Enter your franchise tax from Form CT-3, line 78, or Form CT-3-A, line 77, plus any net

recapture of credits

37.

38Tax credits claimed before the QETC facilities, operations, and training credit ( see instructions ) 38.

39 Subtract line 38 from line 37

39.

40Enter the higher of the tax on the minimum taxable income base or the ixed-dollar minimum

tax ( from Form CT-3, line 81, or Form CT-3-A, line 80 )

40.

41QETC facilities, operations, and training credit limitation ( subtract line 40 from line 39; if line 40

is greater than line 39, enter 0 on line 40 )

41.

42QETC facilities, operations, and training credit to be used this period ( enter the amount from

	line 36 or line 41, whichever is less; see instructions )	42.
43	Unused QETC facilities, operations, and training credit ( subtract line 42 from line 36; see instr. )...	43.
44	Amount of unused credit to be refunded ( see instructions )	44.

45Amount of unused credit to be applied as an overpayment to next period ( subtract line 44

from line 43; see instructions )

45.

6194110094

	Please file this original scannable
61904110094	form with the Tax Department.