Form 8974:
(Rev. December 2017)
Qualified Small Business Payroll Tax Credit for Increasing Research Activities
Department of the Treasury — Internal Revenue Service
950817
OMB No. 1545-0029
Employer identification number (EIN)
Name (not your trade name)
The credit from Part 2, line 12, will be
reported on (check only one box):
Form 941, 941-PR, or 941-SS
Form 943 or 943-PR
Form 944 or 944(SP)
Calendar year
You must select a quarter if you file Form 941, 941-PR, or 941-SS.
Report for this quarter . . .
Check only one box.
1: January, February, March
2: April, May, June
3: July, August, September
4: October, November, December
Part 1: Tell us about your income tax return.
(a)
Ending date
of income
tax period
(b)
Income
tax return
filed that
included
Form 6765
(c)
Date income
tax return
was filed
(d)
EIN
used on
Form 6765
(e)
Amount from
Form 6765, line 44,
or if applicable,
the amount that
was allocated
to your EIN
(f)
Amount of credit
from column (e)
taken on a
previous period(s)
(g)
Remaining credit
(subtract column (f)
from column (e))
1
/ / / /
.
. .
2
/ / / /
.
. .
3
/ / / /
.
. .
4
/ / / /
.
. .
5
/ / / /
.
. .
6
Add lines 1(g) through 5(g) and enter the total here . . . . . . . . . . . . . . . . . . .
.
Determine the credit that you can use this period.Part 2:
7 Enter the amount from Part 1, line 6(g) . . . . . . . . . . . . . . . . . .
7
.
8
Enter the amount from Form 941 (941-PR or 941-SS),
line 5a, Column 2; Form 943 (943-PR), line 3; or Form
944 (944(SP)), line 4a, Column 2 . . . . . . . 8
.
9
Enter the amount from Form 941 (941-PR or 941-SS),
line 5b, Column 2; or Form 944 (944(SP)), line 4b,
Column 2 . . . . . . . . . . . . . . . 9
.
10 Add lines 8 and 9 . . . . . . . . . . . . 10
.
11
Multiply line 10 by 50% (0.50). Check this box
if you're a third-party payer of sick pay or
check this box if you received a Section 3121(q) Notice and Demand. See the
instructions before completing line 11 . . . . . . . . . . . . . . . . . . 11
.
12 Credit. Enter the smaller of line 7 or line 11. Also enter this amount on Form 941 (941-PR
or 941-SS), line 11; Form 943 (943-PR), line 12; or Form 944 (944(SP)), line 8 . . . . . 12
.
For Paperwork Reduction Act Notice, see the separate instructions.
www.irs.gov/Form8974 Cat. No. 37797C
Form 8974 (Rev. 12-2017)