Free 2001 TC-40V - Utah

Utah State Tax Commission

Clean Fuel Vehicle Tax Credit

TC-40V
Rev. 12/01

Taxpayers may claim a nonrefundable credit on their individual income tax, corporate franchise tax or fiduciary tax returns for the purchase or conversion of vehicles that use cleaner-burning fuels. A separate form must be completed and attached to the individual or corporate franchise tax return for each vehicle claimed. If the credit claimed exceeds the tax liability for a taxable year, the credit that exceeds the liability may be carried forward for up to five taxable years. See instructions on reverse side. NOTE: Hybrid vehicles do not qualify for this credit. Part A - This section must be completed by the taxpayer.
Taxpayer's name Address Vehicle Identification Number Telephone number City Social security number or EIN State and ZIP code

Part B - This section must be completed by the Division of Air Quality, Department of Environmental Quality.
Indicate the following: 1. The vehicle is fueled by: 2. 3. propane compressed natural gas electricity other___________; or

The vehicle meets clean fuel vehicle standards in the federal Clean Air Act Amendments of 1990, Title II. Conversion or

(A vehicle manufactured OEM Vehicle to use a clean fuel)

Certification by the Division of Air Quality, Department of Environmental Quality
I certify to the best of my knowledge and belief that the information contained in Parts A and B above are true and complete. Date signed DEQ original stamp of approval (required) Authorized signature (required) X Title

Part C - This section must be completed by the taxpayer.
Amount of qualifying expenditures $
IMPORTANT - PLEASE READ Refer to the instructions for your INCOME TAX (TC-40), CORPORATE TAX (TC-20 or TC-20S), or FIDUCIARY TAX (TC-41) return to determine the line number on which you will record this credit.

Amount of credit claimed (See General Instructions on reverse side for credit limitations) $

For further information regarding: The tax credit, contact the Utah State Tax Commission at (801) 297-2200 or 1-800-662-4335, if outside the Salt Lake City area. Certification, contact the Department of Environmental Quality, Division of Air Quality at (801) 536-4000. Americans with Disabilities Act accommodations: For tax information, contact the Tax Commission at (801) 297-3811 (TDD 297-3819). Please allow three working days for a response. For Certification information, contact the Department of Environmental Quality at (801) 538-6121.

The tax credit must be certified and claimed in the taxable year in which the item is purchased. The Air Quality Certification signature may be obtained by mailing or presenting this form with the required documentation to Department of Environmental Quality, Division of Air Quality, 150 North 1950 West, SLC, UT 84116-0385, telephone (801) 536-4000. Taxpayers may claim a tax credit against state individual income tax, corporate franchise tax or fiduciary tax as follows: OEM Vehicles: 50 percent of the incremental cost* of a new vehicle minus any grant received, up to $3,000 per vehicle registered in Utah if: (1) It is fueled by propane, compressed natural gas, or electricity; (2) It is fueled by another fuel determined by the Air Quality Board to be as effective as the above listed fuels; or (3) It meets the clean fuel vehicle standards in the Federal Clean Air Act Amendments of 1990, Title II; and (4) A previous owner did not take the same credit. *Incremental cost is the difference between the cost of a new vehicle and the cost of the same model without the clean fuel system. NOTE: Hybrid vehicles do not qualify for this credit. Converted Vehicles: 50 percent of the cost of equipment for conversion minus any grant received, up to $2,500 per vehicle registered in Utah if: (1) It is to be fueled by propane, compressed natural gas, or electricity; (2) It is to be fueled by another fuel determined by the Air Quality Board to be as effective as the above listed fuels; or (3) It will meet the clean fuel vehicle standards in the Federal Clean Air Act Amendments of 1990, Title II. Converted Special Fuel Mobile Equipment Engines: 50 percent of the cost of equipment for conversion of special mobile equipment engine minus any grant received, up to $1,000 per special mobile equipment engine, if: (1) It is to be fueled by propane, compressed natural gas, or electricity; (2) It is to be fueled by another fuel determined by the Air Quality Board to be: a. As effective as the above listed fuels, or b. Substantially more effective in reducing air pollution than the fuel for which the engine was originally designed. Procedures Taxpayers who purchase a qualifying vehicle shall submit the following documentation with this form to the Division of Air Quality(1) a copy of the Manufacturer's Statement of Origin; (2) an original or copy of the purchase order, customer invoice, or receipt including the vehicle identification number (VIN) in the taxpayer's name; (3) a copy of the Manufacturer's Suggested Retail Price document that includes a clean fuel option on the equipment list for the vehicle; or in the case of vehicles certified as meeting the Clean Fleet Vehicle standards in Part C of the Act, the owner must make the vehicle available to a representative of the Executive Secretary for verification of an under-hood decal on the vehicle for which the credit is requested. Contact the Division of Air Quality for verification of vehicles located outside the Wasatch Front; and (4) if the vehicle or equipment is a conversion to alternative fuels, then supply (a) documentation of compliance with applicable requirements and the current valid Clean Fuels Tax Credit approval stamp, (b) documentation that the conversion system installed has been certified by the Utah Air Quality Board, by providing the current valid Clean Fuels Tax Credit approval stamp issued by the Executive Secretary, and (c) copies of vehicle inspection reports before and after the conversion, indicating that the vehicle passed the current applicable inspection and Maintenance emission test in the county where the vehicle is registered. The owner is exempt from the vehicle inspection report submission requirements, only if a vehicle is registered and is converted in a county that does not implement any inspection and maintenance program. If the vehicle is registered in a non-inspection and maintenance county, and is converted in an inspection and maintenance county, a vehicle Inspection record is required. Taxpayers who convert a vehicle or special mobile equipment engine shall submit the following documentation to the Division of Air Quality: 1) an original or copy of the purchase order, customer invoice, or receipt provided by an ASE-Certified Mechanic who converted the vehicle or equipment including: (a) conversion kit or equipment manufacturer and model number; (b) date of the vehicle conversion; (c) name, address, and telephone number of the person who converted the vehicle or equipment; and (d) signature of the person responsible for the information on the conversion form. (2) Form TC-40V, Clean Fuel Vehicle Tax Credit, identifying (a) owner's name; (b) social security number or federal identification number; (c) the VIN of the vehicle or model number of the special mobile equipment engine being converted; (d) fuel type before conversion; and (e) fuel type after conversion. Vehicle emission inspection reports before and after the conversion are required for vehicles, except those registered in counties without an inspection and maintenance program.

(3)

The Division of Air Quality must complete Part B and sign and stamp this form for the tax credit to be properly validated. Taxpayers must indicate the amount of qualifying expenditures and credit claimed against their individual income tax, corporation franchise tax or fiduciary tax in Part C. The original completed and signed form must be attached to your tax return. Taxpayers must keep copies of tax credit records for three years from the date the return is filed.