To be eligible for this credit:
You must file this application with the Secretary of Revenue. The application should be filed on or before April 15, 2014, and no later than October 15, 2014. An application filed after October 15, 2014 will not be accepted. Do not attach this application to your North Carolina income tax return. The application must be mailed separately to the address at the bottom of this form. See section B on reverse for additional application requirements. Taxpayers will receive notification of approval of the credit claimed prior to the end of the calendar year. A copy of the approval notification must be filed with the income tax return on which the credit is claimed. List the name(s) of each organization in which you made a qualifying business investment. Attach additional schedules if necessary.
You must submit the following additional documentation with this application:
- Evidence of your investment in the qualified business, including a copy of any stock certificate(s) or subordinated debt instrument(s) issued by the business, and copies of canceled check(s) or other documents which verify your investment.
- Certificate of Qualified Status for each organization for which credit is claimed.
The credit is not allowable if, within three years after the investment was made, you, your spouse, parent, brother, sister, child, or an employee of any of these individuals, or a business controlled by any of these individuals, provided services of any nature to the qualified business for compensation, whether as an employee, a contractor, or otherwise. For other conditions that result in forfeiture of the credit, see section G on reverse.