Income Tax Return for Exempt Businesses under the Puerto Rico Incentives Programs Green Energy
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1 Form (II)EV Rev. 018 Liquidator: Reviewer: Field Audited by: / / R M N Taxpayer's Name Postal Address 20 GOVERNMENT OF PUERTO RICO DEPARTMENT OF THE TREASURY Income Tax Return for Exempt Businesses under the Puerto Rico Incentives Programs Green Energy 20 TAXABLE YEAR BEGINNING ON, AND ENDING ON, Employer Identification Number Department of State Registry No. Serial Number AMENDED RETURN TAXABLE YEAR: 1 CALENDAR 2 FISCAL WEEKS Payment Stamp Industrial Code Municipal Code Part I Zip Code Location of Principal Industry or Business - Number, Street and Country Type of Principal Industry or Business Address of the Contact Person Exempt business under Act (Schedule Y Incentives) Case No. : Tax liability: Less: a) b) c) d) e) f) g) a) b) Merchant's Registration Number Telephone Number - Extension ( ) - Incorporated Day / Month / Year Place Incorporated Schedule Y Incentives, Part II, line (1a) Schedule P Incentives, Part II, line 19 (See instructions)... (1b) Total (Add lines 1(a) and 1(b))... c) Tax withheld at source... Current year estimated tax payments... Excess from previous years not included on line 2(b)... Tax withheld on partners distributable share from partnerships or special partnerships (Form EC)... Amount paid with automatic extension of time or with original return... Tax withheld for professional services (Form 480.6B)... Tax withheld at sources on eligible interest... h) Total payments (Add lines 2(a) through 2(g))... Balance of tax due (If line 1(c) is more than line 2(h), enter the difference here, otherwise, on line 5)... Tax... Interest... Surcharges... (d) Total (Add lines 3(a) through 3(c))... Addition to the Tax for Failure to Pay Estimated Tax (Schedule T Incentives, Part II, line 21)... Excess of tax withheld or paid (See instructions)... Amount paid with the return (Add lines 3(d) and 4 less line 5)... Amount overpaid to be credited to estimated tax for Contribution to the San Juan Bay Estuary Special Fund... Contribution to the Special Fund for the University of Puerto Rico... Amount to be refunded (a) (b) (c) (2a) (2b) (2c) (2d) (2e) (2f) (2g) (3a) (3b) (3c) Receipt No. Amount: Type of Entity Indicate if you are a member of a group of related entities Yes No Group number OATH We, the undersigned, president (or vice president or other principal officer) and treasurer (or assistant treasurer) or agent of the exempt business for which this income tax return is made, each for himself, declare under penalty of perjury, that this return (including the schedules and statements attached) has been examined by us and, to the best of our knowledge and belief, is a true, correct, and complete return, made in good faith, pursuant to the Puerto Rico Internal Revenue Code of 2011, as amended, and the Regulations thereunder. President or vice-president's name Treasurer or assistant treasurer's name Agent's name SPECIALIST'S USE ONLY I declare under penalty of perjury that this return (including the schedules and statements attached) has been examined by me, and to the best of my knowledge and belief is a true, correct and complete return. The declaration of the person who prepares this return is with respect to the information received, and this information may be verified. Specialist's name (Print) Change of Address: Yes No Extension of Time: Yes No Contrats with Governmental Entity: Yes No President or vice-president's signature Treasurer or assistant treasurer's signature Agent's signature Registration number (1c) (2h) (3d) Firm's name Self-employed specialist Specialist's signature Address Zip code NOTE TO TAXPAYER Indicate if you made payments for the preparation of your return: Yes No. If you answered "Yes", require the Specialist's signature and registration number. Retention period: Ten years
2 Form (II)EV Rev. 018 Green Energy Incentives - Page 2 Exempt Business - Comparative Balance Sheet Beginning of the year Ending of the year Assets Total Total Part II Part III Cash on hand and banks... Accounts receivable... Less: Reserve for bad debts... Inventories... Other current assets... Notes receivable... Investments... Depreciable assets Less: Reserve for depreciation Loans receivable of stockholders or related entities 1 Land... 1 Other long-term assets... (12) 1 Total Assets... (13) Liabilities and Net Worth Liabilities 1 Accounts payable... (14) 1 Accrued expenses not paid... (15) 1 Other current liabilities... (16) 1 Long-term notes payable... (17) 1 Notes payable to stockholders or related entities (18) 19. Other long-term liabilities... (19) 20. Total Liabilities... (20) Net Worth 2 Capital stock (a) Preferred stock... (21a) (b) Common stock... (21b) 2 Additional paid in capital... (22) 2 Retained earnings... (23) 2 Reserve... (24) 2 Total Net Worth... (25) 2 Total Liabilities and Net Worth... (26) Net income (or loss) per books... Income tax per books... Excess of capital losses over capital gains... Taxable income not recorded on books this year (Itemize, use schedule if necessary) (a) $ (b) $ (c) $ (d) $ (e) $ (f) $ Total... Expenses recorded on books this year not claimed on this return (Itemize, use schedule if necessary) (a)meal and entertainment (portion not claimed) $ (b) Depreciation $ (c) Vessels, aircrafts and property located outside of P.R. $ (d) Expenses incurred or paid to stockholders, persons or related entities $ (e) $ (f) $ (g) $ (h) $ (i) $ (j) $ Total... Total (Add lines 1 through 5)... ) ( ( ) ( ) ( ) (12) (13) (21a) (21b) (22) (23) (24) (25) (26) Reconciliation of Net Income (or Loss) per Books with Net Taxable Income (or Loss) per Return Income recorded on books this year not included on this return (Itemize, use schedule if necessary) (a) Exempt interest $ (b) $ (c) $ (d) $ (e) $ (f) $ (g) $ Total... Deductions on this tax return not charged against book income this year (Itemize, use schedule if necessary) (a) Depreciation $ (b) $ (c) $ (d) $ (e) $ (f) $ (g) $ (h) $ (i) $ Total Total (Add lines 7 and 8) Net taxable income (or loss) per return (Subtract line 9 from line 6)... Retention Period: Ten years (14) (15) (16) (17) (18) (19) (20)
3 Form (II)EV Rev. 018 Part IV Part V Part VI Balance at beginning of year... Net income per books... Other increases (Itemize, use schedule if necessary) Total (Add lines 1, 2 and 3)... line 4)... Questionnaire If a foreign corporation, indicate if the trade or business in Puerto Rico was YES NO N/A YES NO N/A held as a branch... If a branch, indicate the percent that represents the income from sources 10. Have you been audited by the Federal Internal Revenue Service (IRS)?. Which years? within Puerto Rico from the total income of the exempt business: % Did the exempt business keep any part of its records on a computerized 1 Did the exempt business distribute dividends other than stock dividends or distributions in liquidation in excess of the current and accumulated system during this year?... earnings during this year?... The exempt business books are in care of: Name 1 Is the exempt business a partner in a partnership or special partnership? (If more than one, submit detail)... (12) Address Name of the Partnership or Special Partnership Employer identification number 1 Did the corporation at the end of the taxable year own, directly or Telephone indirectly, 50% or more of the voting stocks of a corporation who is Indicate accounting method used for tax purposes: engaged in trade or business in Puerto Rico?... (13) Cash Accrual If Yes, attach a schedule showing: (a) name and employer identification Other (specify): number, (b) percentage owned, and (c) taxable income (or loss) before Did the exempt business file the following documents? net operating loss and special deductions of the corporation for the (a) Informative Return (Forms 480.6A, 480.6B, 480.6C)... (6a) taxable year (even when such taxable year does not coincide with (b) Withholding Statement (Form 499R-2/W-2PR)... (6b) the one of the corporation or partnership for which this return is filed). If the gross income of the entity or controlled group exceeds $3,0,0, did 1 Did any individual, partnership, corporation, estate or trust at the end you submit financial statements audited by a CPA licensed in Puerto Rico? of the taxable year own, directly or indirectly, 50% or more of the Number of employees during the year: corporation's voting stocks? If Yes, attach a schedule showing the (14) (a) Production: (b) Non-production: name and employer identification number. 9. Did the corporation claim expenses connected to the ownership, use, Enter the percentage owned: % maintenance and depreciation of: (a) Vehicles?... (9a) (b) Vessels?... (9b) 1 Enter the amount of exempt interest: 1 Does the exempt business have other exempt activities not covered under the Green Energy Acts? (Attach schedule)... (16) Was more than 80% of the total income derived from activities Under which act? exclusively related to fishing or transportation of passengers or cargo or lease?...(9b1) 1 Have you made an election of flexible tax exemption under Art. 15 of Act ?... (17) (c) Aircrafts?... (9c) Was more than 80% of the total income derived from activities 1 Enter the total amount of charitable contributions to municipalities claimed during the taxable year: exclusively related to transportation of passengers or cargo or lease?... (9c1) 19. Indicate if your books reflect premiums paid by unauthorized insurers 20. Indicate the method used to allocate expenses: (19) (d) Residential property outside of Puerto Rico?... (9d) Profit - Split Cost Sharing Others Was more than 80% of the total income derived from activities exclusively related to the lease of property to non related persons? (9d1) 2 Employer number assigned by the Department of Labor and Human Resources (e) (9e) 2 Did the corporation claim expenses related to services provided by (f) nonresidents of Puerto Rico? (Total $ ) (See inst.)... (22) Housing? (except business employees)... Employees attending conventions outside of Puerto Rico or the United States?... Name of officer Green Energy Incentives - Page 3 Analysis of Unappropiated Retained Earnings per Books Distributions: (a) Cash... (5a) (b) Property... (5b) (c) Stocks... (5c) (9f) Social security number 2 2 Compensation to officers Other decreases (Use schedule if necessary) Total (Add lines 5 and 6)... Balance at end of year (Subtract line 7 from (a) Did you pay the corresponding sales and use tax?... (22a) Did the corporation claim depreciation expenses for tangible personal property acquired outside of Puerto Rico, for use in its operations not covered by a tax exemption decree?... (23) (a) Did you pay the corresponding sales and use tax?... (23a) Did the corporation pay deemed dividend during the previous year? If Yes, indicate the amount $ (24) Percentage of time devoted to business Percentage of stocks owned Common Preferred Total compensation to officers... Retention Period: Ten years Compensation
4 Schedule Y Incentives Rev. 018 Taxpayer s Name Type of Business Effective period for income: Begins: Ends: Part I Net Income Subject to Tax Part II Tax Computation INCOME TAX FOR EXEMPT BUSINESSES UNDER ACT To be filed with Form (II)EV Taxable year beginning on, and ending on, Type of Decree: Employer Identification Number New Renegotiated Converted Case Number : Number of jobs directly related with the manufacture or designated service: Current: Required by Decree: Net operating income (or loss) for the year (Part IV, line 45)... Net operating loss from preceding year (See instructions)... Net green energy income subject to special deduction (Subtract line 2 from line If it is equal or less than 0, do not continue)... Investment on buildings, structures, machinery and equipment special deduction... Net green energy income subject to tax (Subtract line 4 from line 3) ( Act )... Fixed tax rate on Green Energy Income Total tax (Multiply line 5, Part I by line 1)... Recapture of credit claimed in excess (Schedule B Incentives, Part I, line 3)... Tentative tax (Add lines 2 and 3) Less credits: a) Credit for purchases of products manufactured in Puerto Rico (Schedule Y1 Incentives, Part I, line 6)... (5a) b) Credit for job creation (Schedule Y1 Incentives, Part II, line 5)..... (5b) c) Credit for investment in research and development (Schedule Y1 Incentives, Part III, line 7(a))... (5c) d) Credit for the transfer of intellectual property (Schedule Y1 Incentives, Parte IV, line 5)... (5d) e) Credit for donation of an eligible conservation easement or donation of eligible land.... (5e) f) Credit for construction investment in urban centers (See instructions).... (5f) g) Other applicable credits (See instructions)... (5g) h) Total credits (Add lines 5(a) through 5(g))... Net tentative tax (Subtract line 5(h) from line 4) Minimum tax rate: 7(a) 3% 7(b) 4% 7(c) other % Minimum tentative tax (Multiply line 5, Part I by line 7) Less: Tax withheld on royalty payments Minimum tax (Subtract line 9 from line 8) Total tax liability (Enter the larger of lines 6 and 10. Transfer to Form (II)EV, Part I, line 1(a))... 1 Enter here: 95% of line (a) and 5% of line Retention Period: Ten years (5h) (12b) 20 4%
5 Rev. 018 Part III Gross Profit on Sales or Production and Other Income Schedule Y Incentives - Page 2 Net sales of goods or products (See instructions)... Less: Cost of goods sold or direct costs of production Inventory at the beginning of the year 1 "C" 2 "C" o "MV"... Purchase of materials or merchandise... Direct wages... Other direct costs (From Part V, line 13)... Cost of goods available for sale (Add lines 2 through 5)... Less: Inventory at the end of the year 1 "C" 2 "C" o "MV"... Total cost of goods sold or direct costs of production (Subtract line 7 from line 6) Gross profit (or loss) on sale of goods or products (Subtract line 8 from line 1)... Designated services income... Rent... Interests... Royalties... Other income (Submit detail)... Total income (Add lines 9 through 14)... Part IV Deductions and Net Operating Income 1 Compensation to officers (Complete Part VI of the return)... 1 Salaries, commissions and bonuses to employees... 1 Commissions to businesses Social security tax (FICA) Unemployment tax... 2 State Insurance Fund premiums... 2 Medical or hospitalization insurance... 2 Insurance... 2 Interests... 2 Rent... 2 Property tax: (a) Personal (b) Real... 2 Other taxes, patents and licenses (Submit detail)... 2 Losses from fire, hurricane, theft or other casualties Automobile expenses (Mileage ) (See instructions) Other motor vehicle expenses (See instructions)... 3 Meal and entertainment expenses (Total ) (See instructions)... 3 Travel expenses... 3 Professional services... 3 Contributions to pension or other qualified plans (See instructions. Submit Form AS 6041)... 3 Depreciation and amortization (See instructions. Submit Schedule E)... 3 Bad debts (See instructions. Submit detail)... 3 Charitable contributions... 3 Repairs Royalties Management fees... 4 Expenses incurred or paid for services received from persons not engaged in trade or business in Puerto Rico... 4 Expenses incurred or paid for qualified disaster assistance payments to employees (See instructions)... 4 Other deductions (See instructions. Submit detail)... 4 Total deductions (Add lines 16 through 43)... 4 Net operating income (or loss) for the year (Subtract line 44 from line 1 Enter here and in Part I, line 1)... Part V Other Direct Costs Salaries, wages and bonuses... Social security tax (FICA)... Unemployment tax... State Insurance Fund premiums... Medical or hospitalization insurance... Other insurances... Excise taxes / Use taxes... Retention Period: Ten years Cost sharing allocation Repairs Utilities... 1 Depreciation (Submit Schedule E)... 1 Other expenses (Submit detail)... 1 Total other direct costs (Add lines 1 through 1 Transfer to Part III, line 5)... (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) (22) (23) (24) (25) (26) (27) (28) (29) (30) (31) (32) (33) (34) (35) (36) (37) (38) (39) (40) (41) (42) (4) (44) (45) (12) (13)
6 Schedule Y1 Incentives Rev. 018 Taxpayer s Name COMPUTATION OF TAX CREDITS FOR EXEMPT BUSINESSES UNDER ACT To be filed with Form (II)EV Taxable year beginning on, and ending on, 20 Employer Identification Number Part I Credit for Purchases of Products Manufactured in Puerto Rico Eligible purchases of products manufactured in Puerto Rico: Manufacturing business from which Employer identification number Manufacturing business the product is acquired identification number (a) (b) (c) Regular (d) Purchases value Recycled (e) Total purchases value..... Allowable purchases credit: a) Products manufactured in Puerto Rico (Multiply line 1, Column (d) x 25%)... (2a) b) Products made from recycled materials (Multiply line 1, Column (e) x 35%)... (2b) c) Total credit (Add lines 2(a) and 2(b))... Credit carried from previous years (Submit schedule)... Total available credit (Add lines 2(c) and 3)... Total tax (See instructions)... Credit to be claimed (Up to 50% of line Transfer to Schedule Y Incentives, Part II, line 5(a))... Carryforward credit to subsequent years (Subtract line 6 from line 4)... Part II Credit for Job Creation Did you include with the return the certification from the Executive Director of the Puerto Rico Industrial Development Company? Yes No Jobs created during the first year of operations by industrial zone: a) Vieques and Culebra x $ 5, (1a) b) Low development x $ 2,5... (1b) c) Intermediate development x $ 1, (1c) d) High development x $ (1d) Job creation credit (Add lines 1(a) through 1(c))..... Less: Year Amount... (3b) c) Total (Add lines 3(a) and 3(b)).... (3c) Available credit (Subtract line 3(c) from line 2)... Credit to be claimed in the current year (Transfer to Schedule Y Incentives, Part II, line 5(b))..... Carryforward credit to subsequent years (Subtract line 5 from line 4)... Part IIII Credit for Investment in Research and Development of Green Energy Sources Did you include with the return the certification from the Executive Director of the Puerto Rico Industrial Development Company? Yes No a) b) Other economic incentives received for job creation... (3a) Credit claimed in previous years: Eligible special investment (Detail in Part V) Allowable investment credit (Multiply line 1 x 50%)... Credit attributed against the tax liability for the current year (Up to 50% of line See instructions) Credit carried from previous years (Submit schedule).... Total available credit attributed to the tax liability for the current year (Add lines 3 and 4)... Total available credit (Add lines 2 and 4) Less: a) Credit to be claimed against the tax liability for the current year (Not more than line Transfer to Schedule Y Incentives, Part II, line 5(c)) (7a) b) Credit transferred to another person (7b) c) Total (Add lines 7(a) and 7(b))... Carryforward credit to subsequent years (Subtract line 7(c) from line 6)..... (7c) Part IV Credit for the Transfer of Intellectual Property Total royalty payments... Allowable royalty credit (Multiply line 1 x 12%)... Credit carried from previous years (Submit schedule)... Total available credit (Add lines 2 and 3) Credit to be claimed (Transfer to Schedule Y Incentives, Part II, line 5(d))... Carryforward credit to subsequent years (Subtract line 5 from line 4)..... Retention Period: Ten years (2c)
7 Rev. 018 Schedule Y1 Incentives - Page 2 Part VI Detail of Expenses that Qualify as Special Eligible Investment Complete this part to detail the expenses of line 1, Part III of this Schedule. Expenses incurred during the taxable year for which this return is filed Salaries, commissions and bonuses to employees... Payroll expenses Professional services... Insurance.... Property taxes... Other taxes, patents and licenses.... Rent... Repairs and maintenance... Utilities.... Materials and supplies... Other expenses (Submit detail).... Total (Transfer to line 1, Part III of this schedule).... Retention Period: Ten years (12)
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