PDF document
- 1 -

Enlarge image
                                                    DR 0078 (07/25/14) 
    *140078==19999*                                 COLORADO DEPARTMENT OF REVENUE 
                                                    Denver, CO  80261-0005

                 Application for Extended Enterprise Zone Tax Credits
                              in Terminated Enterprise Zone Area
           Joint Certification by Taxpayer and Enterprise Zone Administrator
I. Enterprise Zone            Date  termination  of  this  area  officially  announced: (MM/DD/YY)  Effective  date  of  termination  of  this  zone  area: (MM/DD/YY)

II. Corporation  or Last Name                                                           First  Name                        Middle  Initial

Colorado  Account  Number                                                               SSN  or  FEIN

Mailing  Address                                                       City                                          State Zip

Contact  Person's  Last  Name                                                           First  Name                        Middle  Initial

Location  of  Enterprise  Zone  Facility                               City                                          State Zip

Date  Established/Acquired/Planned  to  be  Established  by  Taxpayer (MM/DD/YY)                    Phone Number
                                                                                                    ( )
III.  Describe business planning documentation in place prior to the announcement of the zone termination 
    (do  not  attach;  retain  with  your  tax  records  and  send  only  if  specifically  requested  by  the  Department):
    Real  estate                          Plant  or  equipment                            Permit  applications  (zoning,  building,   
  acquisition  plans                       purchasing  specifications                     environmental,  etc.)
     Utility  service  applications       Financing  plans                               Other

If other, please describe

IV.  Planned  Activity Eligible  for Enterprise Zone  Tax Credits   
    through  ten  years  following  termination  of  zone.
                                                                                                      Amount  of 
                                         Tax Credit                                                                  Cumulative   
   For  each  applicable  credit,  first  list  only  the  planned  and  cumulative  total  amounts   Planned 
when  requesting  the  certification.    Then,  complete  the  areas  to  designate  the  year  and   Investment,   Total  Anticipated  
                          amount  of  each  credit  claimed.                                          Jobs,  etc.    Tax Credits

Contribution  to  enterprise zone  administrator credit
                                                                                                    $               $
    Year
    (YYYY)
    Credit 
    Claimed
Investment tax credit
                                                                                                    $               $
    Year
    (YYYY) 
    Credit 
    Claimed
Job  training  tax credit
                                                                                                    $               $
    Year
    (YYYY)
    Credit 
    Claimed



- 2 -

Enlarge image
*140078==29999*

New business facility (NBF) employee credit
                                                                            $
Year
(YYYY)
Credit 
Claimed
Agricultural  processing NBF employee credit
                                                                            $
Year
(YYYY)
Credit 
Claimed
NBF employee health  insurance credit
                                                                            $
Year
(YYYY)
Credit 
Claimed
V.  Joint  Certification  by  Taxpayer  and  Enterprise  Zone  Administrator
We hereby certify to the Colorado Department of Revenue that the information provided herein is true and correct to the 
best of our knowledge.
Taxpayer Signature                          Title                           Date (MM/DD/YY)

Enterprise Zone Administrator Signature                                     Date (MM/DD/YY)



- 3 -

Enlarge image
                           DR 0078 Instructions

A taxpayer may request an extension of enterprise zone        Extended credits are available only to the taxpaying entity 
tax credits in:                                               that existed in the enterprise zone and filed the application 
• a terminated enterprise zone area for up to 10 tax years,   for the extended credits. There is no provision for the 
 and                                                          transfer of those credits to a subsequent related entity.
• a terminated enhanced rural enterprise zone area for up  
  to 5 years                                                  Nothing in this certification shall be construed to grant tax 
following the termination year. The taxpayer must jointly     benefits that have been repealed by the general assembly 
certify with the zone administrator that plans were in place  or to grant tax benefits in excess of the limits established 
for job creation, investment in job training programs, or     by law.
capital expansion before the announcement of the zone 
                                                              Section IV: When first filing this form to request  
termination. Detailed business planning documentation 
                                                              certification, information is required for each tax credit 
supporting the planned investment and job increases must 
                                                              that is expected to be claimed during the extended credit 
be kept with your tax records and supplied to the zone 
                                                              period. Provide the cumulative total of the amount of 
administrator or the Department of Revenue upon request. 
                                                              investment, job training program expenditures, or number 
[C.R.S. 39-30-103(6)(a)]
                                                              of NBF employees that will qualify for the credit and the 
Submit this form and a summary of the business plan to        cumulative total of the anticipated tax credits over the next 
the local enterprise zone administrator. Upon review and      five or ten year extension period. If the five-year extension 
approval, the zone administrator will sign the certification  is claimed for the enhanced rural enterprise zone credit, 
form and return it to the mailing address provided.           write "enhanced" after the name of the credit.

Retain the certified form with your tax records. For any year When preparing your tax return each year during the five 
in which credits are earned and claimed the form must be      or ten year extended period, provide the tax year and 
updated and, along with Form DR 0074, submitted to the        the amount of the credit that is actually claimed during 
local enterprise zone administrator for certification. The    that year in the boxes provided below each credit. The 
zone administrator will return the certified forms, which     cumulative total of each tax credit claimed during the 
must be filed with your Colorado income tax return. For tax   extension period can not exceed the amount originally 
years 2012 and after, any enterprise zone credit must be      certified in the cumulative total column.
claimed on an electronically filed return. Please see the DR 
1366 form for more details.

                           Colorado  Department of Revenue
                           Denver,  CO  80261-0005
                           Telephone  303-238-SERV(7378)
                           Taxation  Web  site: www.TaxColorado.com
                        Colorado  Office  of  Economic  Development  and  International  Trade
                           1625  Broadway,  Suite  2700
                                                    Denver,  CO  80202
                           Telephone  303-892-3840
                        For  a  list  of  Zone  Administrators  and  their  contact  information,  visit:
                           www.AdvanceColorado.com/EZ






PDF file checksum: 3140406747

(Plugin #1/9.12/13.0)