Form Rev 41 0077E PDF Details

Form Rev 41 0077E is a new form that the IRS has released to help individuals and businesses with their tax filings. This form replaces Form 1065, which was used for business income tax filings. The IRS has released this form to help make the tax filing process easier for taxpayers. This form is shorter and simpler than Form 1065, and it includes all of the information that taxpayers will need to report their business income. Taxpayers who use this form can expect to receive a faster response from the IRS when they file their taxes.

Form NameForm Rev 41 0077E
Form Length2 pages
Fillable fields0
Avg. time to fill out30 sec
Other namesAssessments, FTE, 2008, city of everett b o tax form

Form Preview Example

Washington State

Department of Revenue

Taxpayer Account Administration

Special Credits & Assessments


PO Box 47476

Olympia WA 98504-7476

Rural Area Application

for B&O Tax Credit on New Employees

Application for tax credits must be made within 90 days after the actual hiring of qualified employment positions. A new application must be submitted after each group of four consecutive quarters that you project employment to increase over 15%. Positions hired after the end of four consecutive calendar quarters are not considered for this credit. Credit for a position may not be received under both this program and the Software B&O Job Credit Program or the International Services Job Credit Program. This application reflects legislative changes of House Bill 1566 effective January 1, 2008.

Business Identification










Name of Business





















Name of Contact Person (all correspondence will be directed to this person)


























Telephone Number




Zip Code
















Department of Revenue Tax Reporting Account Number
































Department of Employment Security Identification Number































































































Location of the Facility for Which Job Credits are Being Sought





























Please complete one application for each separate facility that is expanding positions.

















Check one:



































Rural County
































































































































Community Empowerment Zone


































Street Address

















































































Zip Code

Does the applicant operate in other Washington locations?


























































































Business Activity to be Conducted at This Business Facility



































If additional space is needed please attach additional pages.



































Describe your manufacturing activity:



































Describe your research and development activities, if applicable:





























Is the applicant engaged in the power and light business, other than in-house co-generation?










































































General Information



































Check one:

If this is to be a new facility, what is the estimated cost of the project?

Business is new



Cost of structure






























Cost of equipment





























Business is expanding




































































































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Employment Information for this Facility (please complete attached worksheet)

Date of first hire


Application is due within 90 days of this date

Calendar Quarter for this date


(Enter this calendar quarter under Quarter A)

Employment for previous four quarters (worksheet is available, if needed)

Calendar Quarter

Total FTEs*

To get average number of FTEs, divide by 4

Total for



To get 15% target, multiply by 1.15. This target is the minimum average for the next year to qualify for the credit.

Employment for current quarter plus estimates for the next three quarters

For current quarter A enter actual amount, if known, or enter estimate.

For remaining three quarters, enter estimates based on expected hired positions.





This quarter includes



Annual report due

first hire date



after this quarter

Calendar Quarter

Total FTEs* New positions under 40K New positions over 40K

To get average number of FTEs, divide by 4. This number must be greater than the target number above, to qualify for the credit.

Total for


* Full Time Equivalent (FTE) positions:

Add the hours during a quarter for all part time employees who worked less than 455 hours. Divide this number by 455, and add to the total of full time employees. This is the number of FTE positions.

Annual Report is required:

Annual reports will be required for two years after application. The first annual report, due within 30 days of the end of Quarter D above, will be used to check how many employees have been hired and affirm that the 15% target has been achieved. The second annual report, due one year after the first report, will be used to confirm that the employees have been retained. See the Annual Report form for additional information.

Future Credits:

You may apply for additional credits as long as each set of four consecutive quarters continues to have expansion that meets the 15% increase. You may apply for future credits in any quarter after Quarter D above. A new application for each facility is required.


Call (360) 902-7175 for assistance.

Return application to:

Taxpayer Account Administration

Special Credits & Assessments

PO Box 47476

Olympia, WA 98504-7476

To inquire about the availability of this form in an alternate format for the visually impaired, please call (360) 705-6715. Teletype (TTY) users may call (360) 705-6718.

REV 41 0077e (3/20/12)

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