Rev 545 Form – Fill Out and Use This PDF

REV-545 (CT) 01-17

RESEARCHANDDEVELOPMENT

TAXCREDIT

2017APPLICATION

SEE INSTRUCTIONS ON PAGES 3 AND 4

BEFORE COMPLETING.

CITY OR TOWN, STATE AND ZIP CODE

CHECKBOXIFASMALLBUSINESS

IF CLAIM IS AS A SMALL BUSINESS WITH TOTAL ASSETS OF LESS THAN $5 MILLION AT THE BEGINNING OR END OF THE YEAR, SUBMIT A BALANCE SHEET REFLECTING TOTAL ASSETS.

ENTERENTITYTYPE(SEEINSTRUCTIONSONPAGE3.)______________________________________________ KOZ-SEEPAGE2.

CALCULATIONOFCREDIT

1. Pennsylvania-qualified research and development (R&D) expenditures (Complete Page 2.):

					UseWholeDollars
	Tax Year Beginning	Tax Year Ending	Actual		Annualized
	MMDDYYYY	MMDDYYYY
	____________________	____________________	$__________________ . . . .	. . . . . . . . . . . . . . . . . . . . . . .	1. $__________________
2.	50 percent of Line 1	. . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .		2. $__________________
3.	Prior years' Pennsylvania R&D expenditures (See instructions on Page 3.):
	Tax Year Beginning	Tax Year Ending	Actual	Annualized
	MMDDYYYY	MMDDYYYY
A.	____________________	____________________	$__________________	A. $__________________
B.	____________________	____________________	$__________________	B. $__________________
C.	____________________	____________________	$__________________	C. $__________________
D.	____________________	____________________	$__________________	D. $__________________
4.	Total of prior years' annualized Pennsylvania R&D expenditures (Sum of A, B, C and D)				4. $__________________
5.	Average of prior years' Pennsylvania R&D expenditures
	(Line 4 divided by number of base years in Line 3 with R&D expenditures)				5. $__________________
	CAUTION:Years with zero expenditure MUST NOT be included when averaging.
6.	Line 1 minus the greater of Line 2 or Line 5		. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .		6. $__________________
7.	Tentative Pennsylvania R&D credit (Line 6 x 0.1 or 0.2 for large or small company, respectively)				7. $__________________

SIGNATUREANDVERIFICATION

Under penalties of perjury, I declare I have examined this return, including any accompanying schedules and statements, and to the best of my knowledge and belief it is true, correct and complete. THIS FORM MUST BE SIGNED BY A CORPORATE OFFICER.

SIGNATURE OF COMPANY OFFICER			FAX NUMBER	DATE
PRINT OFFICER’S NAME	TITLE		TELEPHONE NUMBER	EMAIL ADDRESS
NAME OF PREPARER			PREPARER’S ADDRESS	EMAIL ADDRESS
TELEPHONE NUMBER	PREPARER’S PTIN, FEIN OR SSN	DATE	CITY OR TOWN, STATE AND ZIP CODE

REV-545,PAGE1of4

BREAKDOWNOFR&DEXPENDITURESBYLOCATION

PARTI

		Column 1	Column 2	Column 3	Column 4
Line 1	Federal R&D Expense			$	100%
	PA Location:	PA-Qualified	PA Expenditure	Total Expenditure	Percent of Federal Expense
		Expenditure	Located in KOZ		(Percent of Line 1, Column 3)
Line 2	A	$	$	$	%
Line 3	B	$	$	$	%
Line 4	C	$	$	$	%
Line 5	D	$	$	$	%
Line 6	E	$	$	$	%
Line 7	Non-PA Expenditures			$	%
Line 8	Total	$		$	100%

PARTII

PARTIII

3rd Party

Contact Name

Employer Name

Telephone Number

Fax Number

Email Address

A.

B.

C.

D.

E.

REV-545,PAGE2OF 4

PENNSYLVANIARESEARCHANDDEVELOPMENTTAXCREDITAPPLICATIONINSTRUCTIONS

PERACT7of1997,ACT46of2003,ACT116of2006andAct84of2016

YoumaynowsubmityourResearchandDevelopment(R&D)TaxCreditApplicationviaemailtoRA-RVPACORPRD@pa.gov.Please makesuretosigntheapplication.

Requiredinformation: Completed and signed Page 1 of the 2016 Research and Development Tax Credit Application, completed Page 2 of the 2016 R&D application, completed Page 2 (all three sections) of REV-545 for each year that was not previously submitted with an application, federal Form 6765 or pro forma 6765, balance sheet for a small business and any applicable partnership information (percentage owned). If this is the first year you are submitting this application you must also include federal Form 6765, or a pro forma 6765, for all previous years, as well as Page 2 (all three sections) of REV-545 for each previous year. This information is required even if zero credit is claimed on Line 7 of the application. If you have filed a REV-545 in a prior year and there is a change in the amount of R&D expenditures (Line 3, a-d on Page 1 of REV- 545) between this filing and the prior filing(s), provide a detailed explanation for each change, including supporting documentation.

NOTE: Verify the address on Page 1; it will be used to mail the award letter.

Prior year expenses must be four taxable years immediately preceding the taxable year in which the expense is incurred.

To apply for a PA R&D tax credit, a taxpayer must have qualified PA R&D expenses in the current tax year (Line 1) and in at least one preceding tax year (Line 3). NOTE:IfPAR&DexpenditureswereincurredinaKeystoneOpportunityZone(KOZ),thetaxpayerisnotentitled

to an R&D credit. If you have questions regarding combining a Keystone Opportunity Zone (KOZ) tax credit and a Research and Development(R&D)taxcredit,pleasecall717-772-3896.

For purposes of the PA R&D tax credit, a taxpayer is an entity subject to PA personal income tax or corporate net income tax.

Qualified R&D expenses include research expenses incurred for qualified research and development, as defined in Section 41 (b) of the Internal Revenue Code of 1986, conducted within PA.

A 52-53 week filer whose year ends in the first week of January is considered a calendar year filer.

The department will notify applicants of PA R&D tax credit approvals by mailing award letters by Dec. 15th. A taxpayer may apply the approved credit against his/her PA personal income tax or corporate net income tax liability for the tax year in which the credit is approved. Any unused credit may be carried over for up to 15 succeeding taxable years. A taxpayer is not entitled to carry back, obtain a refund of or assign unused PA R&D tax credits awarded on or prior to Dec. 15, 2002.

Effective for awards made Dec. 15, 2003, and after, the taxpayer can apply to the PA Department of Community and Economic Development, DCED, to sell or assign a PA R&D credit if there has been no claim of allowance filed within one year from the date the Department of Revenue approved the credit. Effective for awards made Dec. 15, 2009, and after, the taxpayer no longer has to wait one year before selling or assigning the credit. However, the taxpayer cannot sell or assign credit until the tax return covering the period including the Dec. 15 award date has been filed.

To apply to sell or assign R&D credit, visit www.dced.pa.gov or contact DCED at 717-214-5422 or 400 North St., 4th Fl., Keystone Building, Harrisburg PA 17120-0225. The purchaser or assignee must use the credit in the taxable year in which the purchase or assignment is made, and the credit cannot exceed 75 percent of the tax liability for the taxable year. The purchaser or assignee may not carry over, carry forward, carry back or obtain a refund of the credit.

Effective for awards made Dec. 15, 2006, and after, pass-through entities include limited liability companies and partnerships, therefore the credit can be transferred (passed-through) in writing to shareholders, members or partners in their proportionate share. The shareholder, member or partner must use the credit in the taxable year in which the transfer is made. Also effective for awards made Dec. 15, 2006, and after, the tentative credit on Line 7 is equal to 10 percent for large companies and 20 percent for small companies.

ENTITY TYPE: Complete the Entity Type on Page 1 by selecting one of the following categories:

Individual,LLC,LLP,Scorporation,Ccorporation,Soleproprietorship

If any tax years on Line 1 or Lines 3A, 3B, 3C or 3D of Page 1 represent a period of less than a full year, (other than for full year 52-53 week filers), the amount(s) of PA R&D expenses must be annualized.

Example: Tax year beginning Jan. 1, 2016, and ending July 31, 2016

Annualized amount = $1,000,000 x 365* = $1,721,698 212

*Use 366 for leap years that include 29 days in February.

If the taxpayer has two or more consecutive short periods that equal one full tax year, the short periods should be combined as a single tax year on Line 1 and Line 3, a-d on Page 1. Submitonlyoneapplication.

REV-545,PAGE3of4

InstructionsforPage2,BreakdownofR&DExpendituresbyLocation

PARTI,Page2

Line 1:

Column 3 – List the Total Qualified Research Expenses from Section A, Section B or Section C of federal Form 6765.

Line 2: Location A

Column 1 – List PA-qualified R&D expenditures for that location.

Column 2 – List PA expenditures located in a KOZ.

Column 3 – List total PA expenditures (sum of Columns 1 and 2).

Column 4 – List percent of federal expense (Line 1, Column 3).

Lines 3 through 6 should be completed for additional PA locations (if more than five locations, make a clean copy of Page 2 to report additional locations).

Line 7:

Column 3 – List total Non-PA R&D expenditures.

Column 4 – List percent of federal expense (Line 1, Column 3).

Line 8:

Column 1 – Total PA-qualified R&D expenditures (this amount should match “Actual” amount on Line 1 of Page 1). Column 3 – Total R&D expenditures everywhere.

PARTII

List address for each location (A, B, etc.).

PARTIII

List contact’s name, employer’s name, telephone number, fax number and email address for each location (A, B, etc.). Check the box if the research was performed by a third party.

NOTE: Complete Page 2 of the R&D application even if all expenses were incurred in PA.

Please carry all totals to the bottom of each column, Part I, Page 2 of the R&D application.

Forinformationonthisandothersaleablerestrictedtaxcreditprograms,pleasevisittheDepartmentofRevenue’sOnlineCustomer Service Center and/or review Corporation Tax Bulletin 2014-04, both accessible at www.revenue.pa.gov. Questions regarding completionoftheapplicationandthecalculationofthecreditmaybedirectedto717-705-6225,Option5,thenOption2.

DonotincludethisapplicationwiththefilingofyourRCT-101,PACorporateNetIncomeTaxReport.

CAUTION:You MUST email your REV-545 and any attachments to ra-rvpacorprd@pa.gov.

CAUTION: When emailing, your application with any supporting documentation must be one document in PDF format to ensure timely and accurate processing.

If submitting more than one application, each application must be a separate attachment in your email.

CHECKLIST:

Before submitting your application, please review the items below and put an X next to each item after you have verified it is complete. This will help to avoid a delay or denial of your application.

_____1. Page 1 and Page 2 (all three parts) of the REV-545 have been filled out in their entirety.

_____2. Included is a copy of federal Form 6765 or a pro forma copy of federal Form 6765 for each year listed with expenditures. Expenditures

are listed under Line 1 and Line 3 on Page 1 of REV-545. *

_____3. Included is a completed Page 2 of REV-545 for each year listed with expenditures. Expenditures are listed under Line 1 and Line 3 on

Page 1 of REV-545.*

_____4. Included is a written explanation of the difference(s) in R&D expenditures between this year’s expenditures and prior filings of REV-545,

if applicable. Supporting documentation is also included.

_____5. If filing as a small business, included is a copy of the balance sheet showing total assets less than $5 million at the beginning or end of

the year.

*NOTE: Only provide items 2 and 3 above for years that had changes in expenditures or years for which this information was not already provided in prior filings of REV-545. However, you must always provide this information for the base year expenditures listed on Line 1 of Page 1.

REV-545,PAGE4of4