$
$ ( )
$
Transferee Name Social Security or Identication Number
Address
City State Zip
Amount of credits transferred:
Amount of credit used:
Balance of credit unused:
Transferor Name Social Security or Identication Number
Address
City State Zip
Amount of Credits Transferred $ Date of Investment *
Signed
* Credits not used in the year invested may be carried forward a maximum of three (3) years from the date of
investment.
Signed
(Transferee must attach a copy of this report to their income tax return)
The Oklahoma Tax Commission is not required to give actual notice to taxpayer of changes in any state law.
Taxpayer
Notary Public
Transferor
Name of Venture Capital Company
Notary Public Affidavit
1)
2)
Title 68 O.S. Section 2357.7 – 2357.8
FORM
518-B
Report of Transfer of Venture Capital Credits
State of Oklahoma
Revised 2015
For the Year Ended:
Oklahoma Tax Commission
Post Office Box 269054, Oklahoma City, Oklahoma 73126-9054
Under penalties of perjury, I declare that I have examined this report and to the best of my knowledge and belief, it is
true, correct and complete.
Signed and subscribed on this day of , before me, a notary public in and
for the state of .
My commission expires
