Form 4255
(Rev. December 2016)
Department of the Treasury
Internal Revenue Service
Recapture of Investment Credit
Attach to your income tax return.
Information about Form 4255 and its separate instructions is at www.irs.gov/form4255.
OMB No. 1545-0166
Attachment
Sequence No. 172
Name(s) as shown on return Identifying number
Properties
Type of property—State whether rehabilitation, energy, qualifying advanced coal project, qualifying gasification project, qualifying advanced energy project,
or qualifying therapeutic discovery project property. (See the Instructions for Form 3468 for the year the investment credit property was placed in service
for definitions.) If rehabilitation property, also show type of building. If energy property, show type.
A
B
C
D
Part I Original Investment Credit
These columns relate to the properties A Properties
through D described above . . . . . . .
A
B C D
1 Original rate of credit . . . . . . . . .
1
2
Credit base as of the end of the previous tax year
(see instructions) . . . . . . . . . . .
2
3
Net change in nonqualified nonrecourse financing
during the tax year. If a net decrease, enter as a
negative number . . . . . . . . . . .
3
4
Credit base as of the end of the current tax year.
Subtract line 3 from line 2 . . . . . . . .
4
5 Refigured credit (see instructions) . . . . . 5
6
Credit taken for this property on Form 3800 in
prior years. See instructions . . . . . . .
6
Part II
Recapture From Increase in Nonqualified Nonrecourse Financing (see instructions)
7
Credit subject to recapture due to a net increase in
nonqualified nonrecourse financing. Subtract line 5
from line 6. If zero or less, enter -0- . . . . .
7
8
Unused general business credits that would have
been allowed if original credit had been figured with
current-year credit base (see instructions) . . .
8
9
Subtract line 8 from line 7. This is the recapture tax
as a result of a net increase in nonqualified
nonrecourse financing . . . . . . . . .
9
Part III
Recapture From Disposition of Property or Cessation of Use as Investment Credit Property
10 Date property was placed in service . . . . 10
11
Date property ceased to be qualified investment
credit property . . . . . . . . . . . .
11
12
Number of full years between the date on line 10
and the date on line 11 . . . . . . . . . 12
13
Unused general business credits that would have
been allowed had there been no credit from this
property (see instructions) . . . . . . . .
13
14 Subtract line 13 from line 6 . . . . . . . . 14
15
Recapture percentage (see instructions) . . .
15
16 Multiply line 14 by the percentage on line 15 . . 16
17 Add property columns A through D, line 9 . . . . . . . . . . . . . . . . . . . . . 17
18 Add property columns A through D, line 16 . . . . . . . . . . . . . . . . . . . . 18
19 Recapture of qualifying therapeutic discovery project grant. Attach statement (see instructions) . . . 19
20
Total increase in tax. Add lines 17, 18, and 19. (See section 45K(b)(4) if you claim the nonconventional
source fuel credit.) Enter here and on the appropriate line of your tax return . . . . . . . . . .
20
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 41488C
Form 4255 (Rev. 12-2016)
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