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West Virginia Schedule CPITC-1 West Virginia
S CPITC-1 Commercial Patent Incentives Tax Credit State Tax
chedule
Rev. 10/15 (For periods AFTER January 1, 2015) Department

Business ID
Name Number
Tax period

BEgInnIng EnDIng
MM DD YYYY MM DD YYYY

♦ Taxpayers desiring to claim the Commercial Patent Incentives Tax Credit for Developing Patents in West Virginia for Direct Use in a
Manufacturing Process or Product must complete Parts A and B of this Schedule.
♦ Taxpayers desiring to claim the Commercial Patent Incentives Tax Credit for Use of a Patent in a Manufacturing Process or Product in
West Virginia must complete Parts A and C of this Schedule.
♦ An owner Taxpayer desiring to claim Commercial Patent Incentives Tax Credit allocated by a Pass-Through Entity subsidiary must
complete Parts A and D of this Schedule.

Under penalties of perjury, I declare that I have examined this credit claim form (including accompanying schedules and
statements) and to the best of my knowledge it is true and complete.

Signature of Taxpayer Name of Taxpayer (type or print) Title Date

Person to contact concerning this return Telephone Number

Signature of Preparer other than Taxpayer Address Date

Part a Commercial Patent Incentives Tax Credit Summary
1. Current year Commercial Patent Incentives Tax Credit for Developing Patents in West Virginia for Direct Use in a
Manufacturing Process or Product from attached Part B, line 9 (Total if more than one qualifying patent). Amounts not
supported by attached Part B will be denied.............................................................................................................................. 1 $
2. Current year Commercial Patent Incentives Tax Credit for Use of a Patent in a Manufacturing Process or Product in West
Virginia from attached Part C, line 5 (total if more than one qualifying patent). Amounts not supported by attached Part C
will be denied............................................................................................................................................................................. 2 $
3. Current year Commercial Patent Incentives Tax Credit Assignment received from a Pass-Through Entity for which the
Taxpayer has an ownership interest. Enter the amount from Total line of Part D. Amounts not supported by attached Part D will
be denied................................................................................................................................................................................... 3 $
4. Unused, Unallocated Commercial Patent Incentives Tax Credit from prior years. Enter the amount from the total line on
Part E. Amounts not supported by a completed Part E will be denied....................................................................................... 4 $

5. Total Commercial Patent Incentives Tax Credit available this tax year (add lines 1 through 4)................................................. 5 $
6. Adjusted Personal Income Tax
a Personal Income Tax – Before application of any tax credits................................. 6a $
b. Other tax credits applied to reduce Personal Income Tax.................................... 6b $

c. Adjusted Personal Income Tax (subtract the amount on line 6b from the amount on 6a). If zero or less, enter zero....... 6c $
7. Commercial Patent Incentives Credit for application against the Personal Income Tax (enter the smaller of the amount on
line 5 and the amount on line 6c here and on the Tax Credit Recap Schedule)........................................................................ 7 $
8. Available Commercial Patent Incentives Tax Credit after application against the Personal Income Tax (subtract line 7 from
line 5)......................................................................................................................................................................................... 8 $

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Schedule CPITC-1 Page 1 of 6
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Business ID
Name Number

Part A – Continued
9. Adjusted Corporation Net Income Tax
a Corporation Net Income Tax – Before application of any tax credits..................... 9a $
b. Other tax credits applied to reduce Corporation Net Income Tax......................... 9b $
c. Adjusted Corporation Net Income Tax (subtract the amount on line 9b from the amount on 9a). If zero or less enter $0........... 9c $
10. Commercial Patent Incentives Credit for application against the Corporation Net Income Tax (enter the smaller of the
amount on line 8 or the amount on line 9c here and on the Tax Credit Recap Schedule).................................................... 10 $
11. Available Commercial Patent Incentives Tax Credit after application against the Corporation Net Income Tax (subtract
line 10 from line 8)................................................................................................................................................................... 11 $
12. Commercial Patent Incentives Tax Credit remaining for allocation. If the Taxpayer is a Pass-Through Entity and any of the
amount on line 11 is to be allocated to the owners of the Pass-Through Entity complete Part F and enter the total amount
of credit to be allocated here................................................................................................................................................... 12 $
13. Unused, unallocated Commercial Patent Incentives Tax Credit for carry forward to subsequent years. Subtract line 12
from line 11.............................................................................................................................................................................. 13 $

Tax Incentive for Developing Patents in West Virginia for Direct Use in a
Part B
Manufacturing Process or Product – Credit Qualification and Credit Calculation
**See the instructions for additional documentation requirements for claimants of the Tax Incentive for Developing
Patents in West Virginia for direct use in a manufacturing process or product**
1. Information on patents developed in West Virginia for which a tax credit is to be claimed:
a. Patent Number......................................................................................................... 1a

b. Date of Patent Application (MM/DD/YYYY)............................................................. 1b / /
c. Patent Assignment.................................................................................................... 1c
d. Patent Classification................................................................................................. 1d
e. Development Location(s)............................. 1e
f. Agreement/Contractual Relationship Entity 1f

g. Agreement/Contractual Relationship Date............................................................... 1g / /
h. Date Patent was sold, leased, or licensed to a third party........................................ 1h / /
2. Total Royalties, License Fees, or other Consideration from sale, lease, or licensing of the patent described in line 1
above. Do not include amounts for any activity, investment, assets, or expenditures for which any Industrial Expansion
and Revitalization Credit (WV Code 13D), Coal Loading Facilities Credit (WV Code 13E), Economic Opportunity
Tax Credit (WV Code 11-13Q), Strategic Research and Development tax Credit (WV Code 11-13R), Manufacturing
Investment Tax Credit (WV Code 13S), or High-Tech Research Zone, Parks and Technology Tax Incentives (WV Code
18B-13) credits or tax incentives have been authorized, taken or allowed............................................................................ 2 $
If the development of the patent described above occurred only in West Virginia, skip to line 6 and enter the amount
from line 2. If some of the development of the patent described above occurred outside West Virginia continue with
line 3.

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Business ID
Name Number

Part B – Continued

3. Direct costs of developing the patent described above that were incurred in West Virginia................................................... 3 $

4. Direct costs of developing the patent described above that were incurred in all locations..................................................... 4 $

5. West Virginia development cost ratio (Divide line 3 by line 4 and enter here)....................................................................... 5 0.
6. West Virginia allocation of patent royalties, license fees, and other consideration (Multiply the amount on line 2 by the
decimal value on line 5.......................................................................................................................................................... 6 $
If any of the credit amount allowed for the tax year previous to the current year was reinvested in the current tax year, complete lines 7a
through 7f to determine the allowable credit percentage for the current tax year. If none of the credit allowed for the previous tax year
was reinvested as indicated in Lines 7b through 7d) or there was no credit schedule completed for the prior tax year, skip to line 8 and
enter 0.20 (20%).
7. Portion of previous tax year credit amount reinvested in current tax year:
a. Commercial Patent Incentives Tax Credit for Developing Patents In West
Virginia for direct use in a manufacturing process or product from prior year.
This amount is from Schedule CPITC-1, Part B, line 9 of the previous tax year.. 7a

b. Amount from line 7a reinvested in depreciable property purchased for purposes
of developing additional patents in West Virginia................................................. 7b

c. Amount from line 7a reinvested in improving upon a patent developed in
West Virginia.................................................................................................... 7c
d. Amount from line 7a contributed to a stipend to retain a graduate or post-
doctoral student in West Virginia integral to the development of the patents or
related technology................................................................................................. 7d

e. Sum of lines 7b, 7c, and 7d................................................................................... 7e
f. Ratio of directed reinvestment of the previous year’s credit amount to the total
previous year credit amount. Divide the amount on line 7e by the amount on
line 7a................................................................................................................... 7f 0.
8. Credit percentage for Commercial Patent Incentives Tax Credit for Developing Patents In West Virginia for direct use in a
manufacturing process or product. If the value on Line 7f is greater than 0.80 (80%), enter 0.30 (30%) here, otherwise enter
0.20 (20%) here...................................................................................................................................................................................... 8 0.
9. Amount of Commercial Patent Incentives Tax Credit for Developing Patents in West Virginia for direct use in a
manufacturing process and product for the current tax year. Multiply the amount on line 6 by the decimal value on line 8.
Enter the resulting product here and on Part A, line 1........................................................................................................... 9 0.

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Business ID
Name Number

Tax Incentive for Use of a Patent in a Manufacturing Process of Product in
Part C
West Virginia that was Developed in West Virginia
**See the instructions for additional documentation requirements for claimants of the Tax Incentive for Use of a
Patent in a Manufacturing Process or Product in West Virginia.**
1. Information on patents used in a manufacturing process or product in West Virginia for which a tax credit is to be claimed:

a. Patent Number 1a

b. Patent Owner 1b

c. Development Location(s) 1c

d. Date Patent was first sold, leased, or licensed to a third party................................. 1d / /
e. Location (s) where the patent was first
used in a manufacturing process or
product in West Virginia.............................. 1e

2. Net profit attributable to the use of the patent described above.............................................................................................. 2 $
If any of the credit amount allowed for the tax year previous to the current year was reinvested in the current tax
year, complete lines 3a through 3e to determine the allowable credit percentage for the current tax year. If none of
the credit allowed for the previous year was reinvested as indicated in lines 3b through 3c, or there was no credit
schedule completed for the prior tax year, skip to line 4 and enter 0.20 (20%).
3. Portion of previous tax year credit amount reinvested in current tax year:
a. Commercial Patent Incentives Tax Credit for Use of a Patent in a Manufacturing
Process or Product in West Virginia that was Developed in West Virginia from prior
year. This amount is from form CPITC-1 Part C, line 5 of the previous tax year...... 3a

b. Amount from line 3a reinvested in capital improvements to add product lines in
West Virginia......................................................................................................... 3b

c. Amount from line 3a reinvested in capital improvements to increase productivity
in West Virginia................................................................................................ 3c

d. Sum of lines 3b and 3c......................................................................................... 3d
e. Ratio of directed reinvestment of the previous year’s credit amount to the total
previous year credit amount. Divide the amount on line 3d by the amount on
line 3a................................................................................................................... 3e 0.
4. Credit percentage for Commercial Patent Incentives Tax Credit for Use of a Patent in a Manufacturing Process or
Product in West Virginia. If the value on Line 3e is greater than 0.80 (80%), enter 0.30 (30%) here, otherwise enter 0.20
(20%) here............................................................................................................................................................................. 4 0.
5. Amount of Commercial Patent Incentives Tax Credit for Use of a Patent in a Manufacturing Process or Product in
West Virginia for the current tax year. Multiply the amount on line 2 by the decimal value on line 4. Enter the resulting
product here and on Part A, line 2.................................................................................................................................. 5 $

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Business                                                       ID
Name                                                           Number

                            Commercial Patent Incentives Tax Credit Allocated 
Part D
                            to Shareholder/Partner from Pass-Through Entity
**See the instructions for additional documentation requirements for claimants of the Tax Incentive for Use of a 
Patent in a Manufacturing Process or Product in West Virginia**
                            Pass Through Entity 
                            Employer Identification 
 Pass-Through Entiy Name    Number (EIN)                             Amount of Credit Assigned
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                                     $
                                                               Total $

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Business                                                                                                            ID
Name                                                                                                              Number

Part E                                                      Unused, Unallocated Commercial Patent Incentives Tax Credit From Prior Years

                                    1                       2              3                   4                        5             6
                                                                                                                                      CPITC unused 
                                                                         Original Amount of 
                                                                                                                                      and unallocated 
                                                            Tax Period   Commercial Patent     CPITC used to      CPITC allocated to 
                                                                                                                                      (subtract the 
                                                            Ending         Incentives Tax    reduce tax liability owners in previous 
                                                     period                                                                          amounts in columns 
                                                            (MM/DD/YYY)  Credit (CPITC)* for in previous years          years
                                      to current tax                                                                                  4 and 5 from the 
                  # of years period                                      indicated Tax Period
                                                                                                                                     amount in column 3
                                    9                           /      / $                   $                    $                  $
                                    8                           /      / $                   $                    $                  $
                                    7                           /      / $                   $                    $                  $
                                    6                           /      / $                   $                    $                  $
                                    5                           /      / $                   $                    $                  $
                                    4                           /      / $                   $                    $                  $
                                    3                           /      / $                   $                    $                  $
                                    2                           /      / $                   $                    $                  $
                                    1                           /      / $                   $                    $                  $
                                                                                                                             Total $
*The Original amount of Commercial Patent Incentives Tax Credit must have been established on a form CPITC-1 for the indicated tax year.

Part F                                                                   Unused Commercial Patent Incentives Tax Credit Allocated to Owners
                                                     Owner name              Owner EIn/SSn       Owner %                             Credit Allocated
                                                                                                                      %      $
                                                                                                                      %      $
                                                                                                                      %      $
                                                                                                                      %      $
                                                                                                                      %      $
                                                                                                                      %      $
                                                                                                                      %      $
                                                                                                                      %      $

Schedule CPITC-1 Page 6 of 6
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