Use your mouse or Tab key to move through the fields. Use your mouse or space bar to enable check boxes.

                                                                                 *62312221W*

       Illinois Department of Revenue 
                                                                                                                                                                       
       Schedule 4255                                            Recapture of Investment Tax Credits
       Attach to Form IL-1040, IL-1120, IL-1065, 
       IL-1120-ST, IL-1041, or IL-990-T.                                                                                                    IL Attachment No. 4

Enter your name as shown on your return.                                   Enter your Social Security number (SSN) or federal employer identification number (FEIN). 
The property you are reporting on Steps 1 through 4 of this schedule was placed in service during the tax year ending:     
                                                                                                                                                Month                  Year 

Step 1:  Figure your Enterprise Zone or River Edge Redevelopment Zone 
         Investment Credit recapture
       A             B                       C                  D                  E            F                                      G                H 
Date property placed Date property           Description of     Reason for       Original basis Name of enterprise                     Credit           Disqualified 
 in service in Illinois  became disqualified qualified property disqualification                zone or river edge                     rate             credit amount
      Month   Year   Month   Year                                                               redevelopment zone                                      (Col. E x Col. G)
1 a  
 b 
 c 
 d 
    e 
    f  

  2  Add Column H, Lines 1a through 1f. Enter the Column H total on Line 11, Column A.                                                       2  

Step 2:    Figure your High Impact Business Investment Credit recapture
       A             B                       C                  D                  E            F                                      G                H 
Date property placed Date property           Description of     Reason for       Original basis Name of the                            Credit           Disqualified
in service in Illinois  became disqualified  qualified property disqualification                foreign trade zone/                    rate             credit amount
      Month   Year   Month   Year                                                               sub-zone                                                (Col. E x Col. G)
3 a                                                                                                                                          .005       
 b                                                                                                                                      .005 
 c                                                                                                                                      .005 
    d                                                                                                                                   .005 
    e                                                                                                                                   .005 
    f                                                                                                                                   .005 

  4  Add Column H, Lines 3a through 3f.  Enter the Column H total on Line 11, Column B.                                                    4 

Step 3:  Figure your REV Illinois Investment Credit recapture
       A             B                       C                  D                  E            F                                      G                H 
Date property placed Date property           Description of     Reason for       Original basis Location of REV                        Credit           Disqualified 
 in service in Illinois  became disqualified qualified property disqualification                Illinois Project                       rate             credit amount
      Month   Year   Month   Year                                                                                                                       (Col. E x Col. G)
5 a                                                                                                                                     .005   
 b                                                                                                                                      .005    
 c                                                                                                                                       .005   
 d                                                                                                                                       .005   
    e                                                                                                                                   .005    
    f                                                                                                                                    .005   

  6   Add Column H, Lines 5a through 5f. Enter the Column H total on Line 11, Column C.                                                          6  

                                                This form is authorized as outlined by the Illinois Income Tax Act. Disclosure of this 
       Schedule 4255 (R-12/22)                  information is REQUIRED. Failure to provide information could result in a penalty.              Page 1 of 3

                                                                               *62312222W*

Step 4:  Figure your Replacement Tax Investment Credit recapture
      A                    B                  C                              D             E                           F              G 
     Date property placed Date property       Description of                 Reason for    Original basis              Credit         Disqualified 
  in service in Illinois  became disqualified qualified property          disqualification                             rate           credit amount
      Month   Year        Month   Year                                                                                                (Col. E x Col. F)
 7 a 
    b 
    c 
    d 
    e 
    f

 8    Add Column G, Lines 7a through 7f. Enter the Column G total on Line 11, Column D.                                        8      

Step 5:   Figure your total Enterprise Zone Investment Credit, or River Edge 
        Redevelopment Zone Investment Credit, High  Impact Business Investment 
        Credit, REV Illinois Investment Credit, and Replacement Tax Investment 
        Credit recapture amount 
                                                                               A           B                           C                         D
                                                                          Enterprise Zone  High Impact                 REV Illinois   Replacement Tax
                                                                             or River Edge Business                    Investment     Investment
                                                                            Redevelopment  Investment Credit           Credit         Credit
                                                                          Zone Investment  recapture                   recapture      recapture
                                                                          Credit recapture
 9   Enter the total basis of all your property. See instructions.      9    
 10  Enter the amount of your original credit. See instructions.         10 
 11  Enter the total disqualified credit amounts from 
     Steps 1, 2, 3, and 4.                                               11  
 12  Subtract Line 11 from Line 10. This is your adjusted credit.        12 
 13  Enter your original tax amount. See instructions.                  13 
 14  Enter the lesser of Line 10 or Line 13. 
     This is the amount of credit you previously used.                   14  
 15  Subtract Line 12 from Line 14. If the result is 
     negative, enter zero.                                               15 
 16  Enter the amount of recapture from any other 
     Schedule 4255 filed this year. See instructions.                    16  
 17  Distributive share of recapture from partnerships 
   and S corporations from Schedule(s) K-1-P.                            17 
 18  Add Lines 15, 16, and 17.                                           18 
 19  Partnerships and S corporations - Enter the amount 
     from Line 18 that you passed through to your partners 
     or shareholders. See instructions.                                  19 
 20  Total Enterprise Zone Investment Credit or River Edge Redevelopment 
     Zone Investment Credit, High Impact Business Investment Credit, 
     REV Illinois Investment  Credit, and Replacement Tax Investment 
     Credit recapture. Subtract Line 19 from Line 18. 
     See instructions.                                                   20  

       If you attach multiple Schedules 4255, complete Step 6 only on the last succeeding Schedule 4255 you complete. If you do not have any 
additional income tax credit recapture amounts, do not complete Step 6.

      Page 2 of 3                             Printed by the authority of the State of Illinois - web only - one copy. Schedule 4255 (R-12/22)   

                                                                             *62312223W*

Step 6:   Figure your additional income tax credit recapture amount
 21   Enter the amount of Angel Investment Credit claimed for any prior year. See instructions.                  21 
 22    Enter the amount of EDGE Credit claimed for any prior year. See instructions.                             22 
   23   Enter the amount of New Construction EDGE Credit claimed for any prior year. See instructions.           23 
 24   Enter the amount of Historic Preservation Credit claimed for any prior year. See instructions.             24 
 25   Enter the amount of New Markets Development Credit claimed for any prior year. See instructions.           25 
 26   Enter the distributive share of additional income tax credit recapture from partnerships and S corporations
      from Schedule(s) K-1-P.                                                                                    26 
 27  Total income tax credit recapture. Add Lines 21, 22, 23, 24, 25, and 26. See instructions.                  27 

        Schedule 4255 (R-12/22)                                                                                  Page 3 of 3
                                                       Reset                 Print