SCHEDULE 
   EOTC-HTM                    ECONOMIC OPPORTUNITY TAX CREDIT                                                 West Virginia 
                               FOR SPECIFIED HIGH TECHNOLOGY MANUFACTURING BUSINESSES ONLY                     Tax Division
   REV05/2022
                                             (FOR PERIODS BEGINNING ON AND AFTER JANUARY 1, 2022)
                   EOTC-HTM SHOULD ONLY BE USED BY APPROVED HIGH TECHNOLOGY MANUFACTURERS WITH AN APPROVED BUSINESS ACTIVITY. 
                                   HIGH TECHNOLOGY MANUFACTURING IS DEFINED IN WV CODE § 11-13Q-10A (2021). 
                                             SECTION A: BUSINESS IDENTIFICATION 
1  FEIN OR SSN                                           WV TAX ID
                                                         TAX PERIOD
2  BEGINNING                                             ENDING
                     MM        DD                   YYYY                               MM            DD                 YYYY
   BUSINESS NAME
3
   TAXPAYER NAME
4
   ADDRESS OF TAXPAYER

5  CITY                                                                                              STATE  ZIP

6  NORTH AMERICAN INDUSTRY CLASSIFICATION SYSTEM CODE (ENTER 6 DIGIT NAICS CODE NUMBER)

                                   SECTION B: INVESTMENT INFORMATION
7  INVESTMENT YEAR(S):                                   ESTIMATED IN-SERVICE 
                                                         DATE OF INVESTMENTS
   INVESTMENT SUMMARY                        COST              PERCENTAGE                                      QUALIFIED
   INVESTMENT WITH USEFUL                                X         33 1/3              %
   LIFE OF 4-6 YEARS
   INVESTMENT WITH USEFUL 
8  LIFE OF 6-8 YEARS                                     X         66 2/3              %

   INVESTMENT WITH USEFUL                                X         100                 %
   LIFE OF 8+ YEARS
   TOTAL QUALIFIED INVESTMENT  

                                              SECTION C: JOB INFORMATION
THE BUSINESS MUST CREATE AND MAINTAIN AT LEAST 20 NEW JOBS IN ORDER TO BE ELIGIBLE TO USE THE CREDIT.
   ANNUAL NEW JOBS/PAYROLL FACTOR COMPUTATION            # EMPLOYEES                                        PAYROLL OF EMPLOYEES
   9A. PRE-CREDIT EMPLOYMENT LEVELS
9
   9B. NEW-JOBS EMPLOYED FOR CREDIT

   9C. TOTAL EMPLOYMENT IN WV
                                   NEW JOBS PAYROLL      TOTAL WV PAYROLL                                   PAYROLL FACTOR
10 PAYROLL FACTOR
                                                         /=
11 MEDIAN COMPENSATION OF NEW JOBS FOR  THE  TAX  YEAR MUST MEET OR EXCEED  THE MEDIAN WAGE  AS 
   PRESCRIBED IN THE ADMINISTRATIVE NOTICE.  

            SECTION D: TAX CREDIT APPLICATION COMPUTATION
  TAX TYPE  PRE-CREDIT LIABILITY      X     PAYROLL FACTOR     = TAX SUBJECT TO CREDIT OFFSET      TAX CREDIT TO BE APPLIED
  12A. B&O                            X                        =

  12B. CNIT                           X                        =
12
  12C. PIT                            X                        =

  TOTAL                               X                        =

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

            SIGNATURE OF TAXPAYER           NAME OF TAXPAYER (PRINT OR TYPE) TITLE                 DATE

  SIGNATURE OF PREPARER OTHER THAN TAXPAYER                      ADDRESS                           DATE

            PERSON TO CONTACT CONCERNING THIS RETURN                                               TELEPHONE

                                 EOTC-HTM
                 WEST VIRGINIA ECONOMIC OPPORTUNITY TAX CREDIT
        FOR SPECIFIED HIGH TECHNOLOGY MANUFACTURING BUSINESSES ONLY

                                 GENERAL INFORMATION
EOTC-HTM should only be used by approved High Technology Manufacturers with an approved business activity. High 
technology manufacturing is defined in WV Code § 11-13Q-10a (2021) and includes the manufacturing of the following: 
• Electronic Computers
• Computer Storage Devices
• Electron Tubes
• Electronic Capacitors
• Semiconductor & Related Devices
• Semiconductor Machinery
• drones, target drones, unmanned aircraft, or unmanned robotic aircraft
• autonomous motor vehicles
• robots, robotic medical machines or equipment, or robotic surgical machines or equipment
• machines, equipment and products predominantly operated by and incorporating artificial intelligence
• biotechnology products
• medical devices

                           APPLICATION FOR CREDIT REQUIRED
Taxpayers must file an application for the West Virginia Economic Opportunity Tax Credit (Form EOTC-A) with the Tax 
Commissioner and receive written acknowledgement of such application prior to claiming the credit. The application must 
be filed annually no later than the due date of the taxpayer’s annual return including extension. Failure to file the application 
timely will result in forfeiture of 50% of the annual credit allowance until the application is filed. 

                         INSTRUCTIONS FOR SCHEDULE EOTC-HTM
Section A  Complete business identification section, including business name, taxpayer name, address, tax year, federal 
           identification number and North American Industry Classification System (NAICS) code in lines 1 through 6.
Section B   INVESTMENT INFORMATION
Line 7     Investment Year(s): The investment window for the Economic Opportunity Tax Credit is normally one full year. 
           Enter the year(s) qualified investment was placed into service.
Line 8     Investment Summary (complete if you made qualified investments during the year) Enter the net costs of the 
           property on the appropriate line determined by the estimated useful life of the property. Then multiply the net 
           costs in by the applicable percentages. Enter the results in the column marked “Qualified”. Add the qualified 
           column to get the Taxpayer’s Total Qualified Investment for the tax year.
Section C   JOB INFORMATION
Line 9a    Column 1 - Enter the number of full-time equivalent employees employed by you and other members of your 
           controlled group within West Virginia during the twelve-month period. This must be prior to the first placement 
           of qualified investment attributable to the Economic Opportunity Tax Credit into service or use. 
           Column 2 - Enter the total dollar amount of the annual payroll associated with these employees for this year. 
Line 9b    Column 1 - Enter the number of full-time equivalent new jobs created as the result of your qualified investment. 
           Column 2 - Enter the total dollar amount of the annual payroll associated with these new jobs for the current year. 
           (High Technology Manufacturers are required to create and maintain at least 20 new jobs to qualify for 
           the credit.)
Line 9c    Column 1 - Enter the total number of full-time equivalent employees employed by you and other members of 
           your controlled group within West Virginia for the current year. 
           Column 2 - Enter the total dollar amount of the annual payroll associated with all employees for the current year.
Line 10    Divide the amount of new jobs payroll from Line 9b Column 2 by the total payroll from Line 9c Column 2.
Line 11    Enter the median compensation paid this year to your new employees. For tax year 2021, the median 
           compensation must be at least $56,600 (See Administrative Notices for values for other years).
Section D    TAX CREDIT APPLICATION COMPUTATION
Column 1   List your pre-credit tax liability by tax type
Column 2   Insert the payroll factor calculated on Line 10
Column 3   Multiply the tax liabilities by the payroll factor to calculate the tax subject to credit offset 
Column 4   Tax Credit to be Applied - List the amount from Column 3 to be applied to the tax liability
Revised 05/2022