m m d d y y y y
(Continued from page 1)
(Continued on page 2)
(Enter also on page 2 line 7)
(From Page 1 Line 6)
(Multiply Line 18 by Line 19)
(Multiply Line 22 by Line 23)
* Determine number of New Jobs eligible for percentage of payroll within one (1) year Attach a schedule listing new full time jobs created (title date created and payroll amount for each year)
: If Short Period See Instructions Below
1 For each month list the number of full time employees subject to Mississippi withholding at this facility at the end of each month
10 Year 3 Increase (Line 7)
11 Year 4 Increase (Line 7
12 Year 5 Increase (Line 7)
13 Year 6 Increase (Line 7)
14 Year 7 Increase (Line 7)
15 Year 8 Increase (Line 7)
16 Year 9 Increase (Line 7)
17 Number of New Jobs Eligible for
18 Number of New Jobs Eligible for Dollar Amount of
19 Dollar Amount of Credit Per Employee
2 Total Employees
20 Eligible Credit for Dollar Amount Per Job
21 Number of New Jobs Eligible for Percentage of Payroll
22 Amount of Payroll for New Jobs (From Line 21)
23 Percentage of Payroll for New Jobs in County Tier
24 Eligible Credit for Percentage of Payroll
25 Total Eligible Jobs Credit (From Lines 20 and 24)
3 Number of Months
4 Average of Full
5 Less Prior Year Average
6 Average Increase in Full Time
6a Number of New Jobs Eligible for Percentage of
7 Average Increase in Full Time
8 Year 1 Increase (Line 7)
9 Year 2 Increase (Line 7)
A current year decrease in employment (Line 7) will reduce Number of New Jobs Eligible for Credit (Line 17) for the current year This is in contrast to an increase of employment in which the increase is delayed a year A qualifying level of increase of employment must be in a single reporting period An employer may not combine two or more periods of increases in employment to qualify for a certain level of employment A period is assumed to be a full fiscal or calender year For additional information see Title 35 Part X Chapter 01 of the Mississippi Administrative Code for Limitations
Attach this form along with the Income Tax Credit Summary (Form 83 401) to your return
Base Year
Computation of
County:
Credit (Add Lines 8 through 16)
Credit (From Page 1 Line 6a)
Credit per Employee
Eligible Credit
Employees
Enter also on form 83 401
Facility
For Period Ending:
Form 83 450 12 8 1 000 (Rev 05/12)
Form 83 450 12 8 2 000 (Rev 05/12)
in Operation
Location:
Mississippi
Month
Name of Entity
New Jobs Credit
Page 1
Page 2
Payroll(Enter also on Page2 line21)*
Percentage of Payroll: Effective January 1 2005 the calculation of the credit was changed to a percentage of payroll for the new jobs instead of a dollar credit per job Use the percentage of payroll for all newly created jobs based on the qualifying increase on or after January 1 2005 Attach a schedule listing new full time jobs created (title date created and payroll amount for each year)
See Instructions below
Short period Return: Credit must be prorated by multiplying the credit per employee by the number of months in the short period and then divide by 12 Credit for jobs created is valid for 60 months Any remaining months caused by a short period may be carried into the sixth period
Time Employees
Year 1
Year 10
Year 2
Year 3
Year 4
Year 5
Year 6
Year 7
Year 8
Year 9