West Virginia Film Industry
                                                                                                                                                       West Virginia 
WV FIIA-TCS                                       Investment Tax Credit                                                                                   State Tax 
Rev. 9/2020                                       (For periods AFTER January 1, 2020)                                                                  Department

Credit Clamant Name                                                    Credit Claimant ID (EIN/SSN)

                     TAX PERIOD BEGINNING                         ENDING
                                              MM  DD      YYYY                  MM      DD                                                         YYYY
PART A     Credit Source and Documentation (Check appropriate source of credit and attach indicated supporting documents)

1.    Production company that earned original credit entitlement.
       ■   Approved Tax Credit Voucher (Form FIIA-08) From West Virginia Film O  ffi   ce.
2.    Owner of production company that earned original credit entitlement.
       ■   Copy of production company’s approved Tax Credit Voucher (Form FIIA-08) From West Virginia Film O  ffi                                              ce.
       ■   Schedule K-1, or similar document, showing the percentage of ownership of the production company.
3.    Credit obtained from a transfer or purchase of approved credit.
       ■   Approved Tax Credit Voucher (Form FIIA-08) From West Virginia Film O  ffi   ce.
4.    Owner of company that received a credit allocation via a transfer or purchase of approved credit.
       ■   Copy of company’s approved Tax Credit Voucher (form FIIA-08) From West Virginia Film O  ffi                                                   ce.
       ■   Schedule K-1, or similar document, showing the percentage of ownership of the company.

PART B     Annual Credit Computation and Reconciliation
5. Enter the beginning and ending dates between which the qualifying  film production BEGINNING
   expenditures occurred.                                                                                                                          MM     DD YYYY
                                                                                     ENDING
                                                                                                                                                   MM     DD YYYY
6. Enter individual West Virginia Film O  ffice Tax Credit Voucher numbers and amounts and total credit amount (Tax Credit
   Voucher(s) must be attached).
                     TAX CREDIT VOUCHER NUMBER                   CREDIT AMOUNT

                                                                                        TOTAL

7. a.  Owners receiving a credit allocation from a subsidiary enter the ownership percentage
       as a decimal to 6 places (Schedule K-1, or similar document, must be attached............. a.
    b. Companies whose name appears on an Approved Tax Credit Voucher from the
       West Virginia Film O  ffice enter 1.000000.......................................................................... b.
8.   Total Available Credit (multiply the amount on Line 6 by the decimal value on Line 7a or b......
9.   Total Available Credit used in prior years....................................................................................
10. Total Available Credit sold or transferred....................................................................................
11. Credit Available This Period (Subtract the amounts on Lines 9 and 10 from the amount on
    Line 8.........................................................................................................................................
12. Corporation Net Income Tax
    a. Enter total Corporation Net Income Tax Liability................................................................. a.
    b. Corporation Net Income Tax Film Industry Investment Tax Credit O ff set (Enter the
       lesser of the amount on Line 11 and the amount on Line 12a) Also enter this amount
       on CIT-120TC.................................................................................................................. b.
13. Credit Available This Period Adjusted for Corporation Net Income Tax O ffset (Subtract the
    amount on Line 12b from the amount on Line 11).....................................................................

Schedule WV/FIIA-TCS                                                                                                                                         Page 1 of 2
Rev. 9/2020

14. Personal Income Tax
 a. Enter total Personal Income Tax Liability............................................................................ a.
 b. Personal Income Tax Film Industry Investment Tax Credit O ff                           set (Enter the lesser of 
    the amount on Line 13 and the amount on Line 14a. Also enter the amount on the Tax 
    Credit Recap Schedule on form IT-140)............................................................................ b.

PART C     Credit Recap
 Tax Year Ending of Total Available Film Investment Tax Credit  (C) Film Industry Invest- (D) Film industry     (E) Film Industry Invest- (F) Ending Balance of Total Available 
                 (A) Beginning Balance   (B) Film Industry 
 (mm/dd/yyyy)    Industry Investment Tax Applied to Corporation ment Tax Credit Applied   Investment Tax Credit ment Tax Credit Sold or   Film Industry Investment Tax Credit 
                     Credit              Net Income Tax         to Personal Income Tax    Allocated to Owners   Transferred               (Column A minus the sum of Columns 
                                                                                                                                          B through E)

NOTES:

■  No Film Industry Investment Tax Credit is allowed after the expiration of the second taxable year after the taxable year 
 in which the expenditures upon which the credit is based occurred.

■  The transfer or sale of the Film Industry Investment Tax Credit does not extend the time in which the credit can be 
 used. The carry forward period for the credit that is transferred or sold begins on the date on which the credit was 
 originally granted by the West Virginia Film O  ffi              ce.

■  No carryback to a prior year is allowed for the amount of any unused portion of any annual credit allowance.

Signature of Taxpayer                                               Name of Taxpayer: Type of Print                                                                                     Title                                                 Date

Person to Contact Concerning this Return                                                                                                                                                                                         Telephone Number

Signature of Preparer other than Taxpayer                Address                                                                                                                          Title                                                 Date

Schedule WV/FIIA-TCS                                                                                                                                                                                                                                Page 2 of 2
Rev. 9/2020