Form Rpd 41289 – Fill Out and Use This PDF

RPD-41289 REV. 09/2009

State of New Mexico - Taxation & Revenue Department

CERTIFICATE OF ELIGIBILITY FOR THE HIGH-WAGE JOBS TAX CREDIT

Name of eligible employer

New Mexico CRS identification number

Compute the high-wage jobs tax credit

9.Total eligible wages and benefits paid to the eligible employee during this period were:

10.Multiply Line 9 by 0.10 (10%).

11.Enter the lesser of Line 10 or $12,000. The high-wage jobs tax credit cannot exceed $12,000 per qualifying period. See the instructions if more than one eligible employee occupied a qualifying job during a qualified period.

$

$

$

15. the qualifying job is located:

in Albuquerque, Las Cruces, Rio Rancho, Roswell, or Santa Fe anywhere else in New Mexico

RPD-41289 REV. 09/2009

State of New Mexico - Taxation & Revenue Department

CERTIFICATE OF ELIGIBILITY FOR THE HIGH-WAGE JOBS TAX CREDIT

INSTRUCTIONS

ABOUT THIS CREDIT: Eligible employers may earn the high- wage jobs tax credit for each qualifying high-wage job created on or after July 1, 2004 and prior to July 1, 2015. The amount of the credit is 10% of wages and benefits paid or distributed to an eligible employee in a high-wage job for a maximum credit of $12,000 per qualified period.

HOW TO COMPLETE THIS FORM: Complete all information requested. Enter the name and the New Mexico CRS identifica- tion number of the employer. This must be the same name and number on Form RPD-41288, Application for High-Wage Jobs

Tax Credit.

Qualification verification.

1. Enter the date the qualifying job was created. The job must be created between 7/1/04 and 6/30/15.

2. Enter the name of the eligible employee occupying the qualifying job. If more than one employee occupied the qualifying job during the current qualifying period, complete a separate Form RPD-41289 for each eligible employee.

3. Enter the qualifying period for which this credit is claimed. See the definition of “Qualifying Period” on this page.

4. Enter the total number of employees with qualified high-wage economic-based jobs employed by the eligible employer at the location at which the job is performed or based on the day prior to the day the qualifying job was created.

5. Enter the total number of employees with qualified high-wage economic-based jobs employed by the eligible employer at the location at which the job is performed or based on the last day of the current qualifying period. For each new qualified high-wage job, the number of high-wage jobs must be at least one more than the number of high-wage jobs employed on the day prior to the day the job was created.

6. Enter the number of previous qualified periods claimed for this job. The high-wage jobs tax credit is limited to four qualifying pe- riods for each job.

7. To qualify for the credit, the eligible employee must receive wages for the qualifying period of at least:

•$40,000 or more if the qualifying job is located in Albu- querque, Las Cruces, Rio Rancho, Roswell or Santa Fe, or

•$28,000 or more if the qualifying job is located anywhere else in New Mexico.

8. Enter a unique 5-digit number identifying this position. It may be any numeric characters you choose, but must remain the same for purposes of reporting the high-wage jobs tax credit. The number must be unique to the position and separate from the employee occupying the position.

Compute the high-wage jobs tax credit.

9. Enter the total wages and benefits paid to the eligible employee during this qualified period.

10. Multiply Line 9 by 0.10 (10%), and enter here.

11. Enter the lesser of Line 10 or $12,000. If more than one qualified employee occupied this job during this period, adjust the amount on Line 11 so that the total credit claimed for qualified employees during this period does not exceed $12,000. A certificate of eligibil- ity for each employee in a qualified job during the qualified period must be included on the same Form RPD-41288, Application for

High-Wage Jobs Tax Credit.

Certifications.

To qualify for the high-wage jobs tax credit, all of the following cer- tifications must be met. Check the boxes that apply and complete the requested information.

12. Certify that the employee who is occupying the job during this period meets the definition of “eligible employee” below.

13. Certify the amount of wages paid to the eligible employee oc- cupying the qualifying job for the qualified period.

14. Certify the number of weeks the employee occupied this job during this qualified period. If less than 48 weeks, write the name of the other employee(s) occupying this job during this period. The total weeks the job was occupied during this period must total 48 weeks. A certificate of eligibility for each qualified employee during the qualified period must be attached and included on the same

Form RPD-41288, Application for High-Wage Jobs Tax Credit.

15. Certify whether the job is performed or based at a location in Albuquerque, Las Cruces, Rio Rancho, Roswell or Santa Fe, or at a location in New Mexico other than these municipalities.

This form must be signed and notarized. Attach the completed certificate to Form RPD-41288, Application for High-Wage Jobs Tax Credit, and mail to: Taxation and Revenue Department, CRS

Section, P.O. Box 630, Santa Fe, NM 87504-0630. The Department will notify you when approved. Once approved, use Form RPD- 41290, High-Wage Jobs Tax Credit Claim Form, to claim the credit against the modified combined tax liability due. Any excess will be refunded. See the instructions for Form RPD-41288 or RPD-41290 for the definition of “modified combined tax liability”.

IMPORTANT: The Department may require you to furnish additional documentation to verify eligibility.

DEFINITIONS:

“Eligible Employee” means any New Mexico resident employed by an eligible employer other than an individual who:

a.bears any of the relationships described in Paragraphs (1) through (8) of the 26 U.S.C. Section 152(a) to the employer or, if the employer is a corporation to an individual who owns, directly or indirectly, more than 50% in value of the outstanding stock of the corporation or, if the employer is an entity other than a corporation to an individual who owns, directly or indirectly, more than 50% of the capital and profits interest in the entity;

b.if the employer is an estate or trust, is a grantor, beneficiary or fiduciary of the estate or trust, or is an individual who bears any of the relationships described in Paragraphs (1) through (8) of 26 U.S.C. Sec- tion 152(a) to a grantor, beneficiary or fiduciary of the estate or trust;

c.is a dependent, as that term is described in 26 U.S.C. Sec- tion 152(a)(9), of the employer or, if the taxpayer is a corporation of an individual who owns, directly or indirectly, more than 50% in value of the outstanding stock of the corporation or, if the employer is an entity other than a corporation of an individual who owns, directly or indirectly, more than 50% of the capital and profits interest in the entity or, if the employer is an estate or trust of a grantor, beneficiary or fiduciary of the estate or trust, or

d.is working or has worked as an employee or as an inde- pendent contractor for an entity that directly or indirectly owns stock in a corporation of the eligible employer or other interest of the eligible employer that represents 50% or more of the total voting power of that entity or has a value equal to 50% or more of the capital and profits interest in the entity.

“Qualifying Period” means the 12 months beginning on the day an eligible employee begins working in a new high-wage economic-based job, or 12 months beginning on the anniversary day an eligible employee began working in a new high-wage economic-based job.

See RPD-41288, Application for High-Wage Jobs Tax Credit instruc- tions for the definitions of “Wages”, “Benefits”, “Eligible employer”, “High-wage economic-based job” AND “Modified combined tax

liability”.