FOR DEPARTMENT USE ONLY BD-100 State Form 51824 (R4/8-10) Approval Amt. Indiana Department of Revenue Biodiesel Tax Credits Application 803 Approved Date Indicate period covered for which gallons were produced, blended, and/or sold: From ____________ To __________ A. Taxpayer Information Company Name TID (Taxpayer Identification Number) FID (Federal Identification Number) State ZIP Code Indiana Location Address City B. Biodiesel Production Credit 1. Total biodiesel produced in Indiana gallons 2. Total biodiesel sold to biodiesel blenders gallons 3. Indiana credit amount (line 2 x $1.00) = $ 4. Attach a schedule of all sales to Indiana blenders including name, address, TID, and gallons sold during this period. C. Blended Biodiesel Credit 1. Total biodiesel purchased from all sources gallons 2. Total biodiesel purchased from Indiana producers gallons 3. Total gallons of blended biodiesel from line 2 blended in Indiana facility 4. Indiana credit amount (line 3 x $.02) = $ gallons D. Retail Sale of Blended Biodiesel Credit (Maximum amount of grant realized) Do Not Use 1. Total gallons of blended biodiesel distributed to an end user in Indiana Do Not Use 2. Indiana credit amount (number of gallons from line 1 x $.01) = $ E. Application of Tax Liability Credits Check boxes that apply to indicate how you anticipate using the net total of the credit(s) computed above: Dollar amount from sections B & C to be applied: State Gross Retail and Use Tax Adjusted Gross Income Tax Financial Institutions Tax Insurance Premiums Tax $ $ $ $ Note: A taxpayer may not take a credit against sales tax collected as a retail merchant, but may take a credit against use tax due on its taxable purchases. F. Signature Under penalties of perjury, I declare that I have examined this document along with any attachments, and to the best of my knowledge and belief, it is true, correct, and complete. Fax to: (317) 615-2697 -orMail to: Indiana Dept. of Revenue Tax Administration P.O. Box 6197 Indianapolis, IN 46204 Printed Name and Title Signature Telephone Number Questions? Call (317) 232-2339 Date  12410111594 American LegalNet, Inc. www.FormsWorkFlow.com Instructions for Biodiesel Tax Credits (BD-100) • Indiana Code (IC) 6-3.1-27 provides biodiesel credits to Indiana producers, blenders, and retailers. Biodiesel is defined as a renewable, biodegradable, mono alkylester combustible liquid fuel derived from agricultural plant oils or animal fats that meets American Society for Testing and Material specification D6751-03a Standard Specification for biodiesel fuel (B100) blend stock for distillate fuels. • The biodiesel production credit and blended biodiesel credits are each limited to a maximum of $3 million per taxpayer for all taxable years but may be increased to $5 million for the biodiesel production credit with prior approval from the Indiana Economic Development Corporation (IEDC). The total of credits allowed for biodiesel production, biodiesel blending, and ethanol production (allowed under IC 6-3.1-1-28) is capped at $50 million for all taxable years of which at least $4 million is provided for each type of production. • The credit for sellers of blended biodiesel fuel to end users may not exceed $1 million for all taxpayers for all taxable years. This credit expires on Dec. 31, 2010, or when the $1 million cap is reached. 2. Multiply the total gallons from line 1 by $.01. Enter the total amount of Indiana credit for blended biodiesel sold. Section E - Application of Tax Liability Credits Please indicate how you anticipate using this credit by checking the appropriate box(es). Combine the amount of credits from sections B, C, and D to be applied against the tax selected. Note: You may not use the credit to offset or reduce the Indiana Gross Retail Sales Tax you collected from your customers. Section F - Signature This claim must be signed by the taxpayer or an authorized agent. If necessary, a properly executed Power of Attorney form must accompany the application. How Soon Will I Receive My Tax Credit Approval? Who May File for This Credit? A producer (certified by the IEDC) who is producing biodiesel at an Indiana facility that will be used to produce blended biodiesel; and/or A blender (certified by the IEDC) who purchases biodiesel produced at an Indiana facility and produces blended biodiesel at an Indiana facility. A retailer is a person who distributes blended biodiesel at retail to an end user in Indiana. How Often Can I File a Tax Credit Application Claim? A claim for credit can be filed monthly, quarterly, semiannually, or annually. Credits will be approved by the Department until the maximum amount of credit for each category has been reached. Section A - Taxpayer Information 1. Type or print name and location address. 2. Enter Indiana taxpayer ID number (TID). 3. Enter federal ID number (FID). Section B - Biodiesel Production Credit Note: Attach certification from the IEDC. 1. Enter total gallons of biodiesel produced at an Indiana location. 2. Enter total gallons of biodiesel sold to biodiesel blenders. 3. Multiply the number of gallons from line 2 by $1. Enter the total amount of Indiana credit for biodiesel production. 4. Create and attach a schedule to include the name, address, TID, and number of gallons sold to each Indiana blender. Section C - Blended Biodiesel Credit Note: Only blended biodiesel produced from Indiana biodiesel is eligible for the credit. Attach certification from the IEDC. 1. Enter the total gallons of biodiesel purchased from all sources. 2. Enter the total gallons of biodiesel purchased from Indiana producers. 3. Enter the total gallons of blended biodiesel generated from the gallons shown on line 2 and blended in an Indiana facility. 4. Multiply the number of gallons from line 3 by $.02. Enter the total amount of Indiana credit for blended biodiesel. The credit claims will be reviewed in the order in which they are received. Processing time will vary depending on the number of credit applications received. Incomplete credit applications will be delayed until we are able to obtain the required information from you. Inquiries regarding processing procedures or the status of your claim may be directed to the Compliance Division at (317) 232-2339. Where Do I Send My Biodiesel Tax Credit Application Claim? Form BD-100 can be faxed to: (317) 615-2697 -orMail form to: Indiana Department of Revenue Tax Administration P.O. Box 6197 Indianapolis, IN 46204 Where Can I Claim This Credit? The Biodiesel Credits can be applied as a credit against the taxpayer’s sales/use tax (IC 6-2.5), adjusted gross income tax (IC 6-3-1 to 6-3-7), financial institution tax (IC 6-5.5), and insurance premium tax (IC 27-1-18-2). A copy of the approved BD-100 must be attached to the return; otherwise, the credit will be disallowed. The credit amount approved on the BD-100 is to be taken as a credit against your tax liability on the return of your choice. Please see your tax returns’ instructions to determine where the credit should be entered on the various tax forms. What If I Do Not Use All of My Credit? Any unused credit can be carried forward for up to six years or until all credits have been used. You can claim the credit on more than one return up to the maximum credit approved on the BD-100. Note: A taxpayer is not entitled to a carryback or refund of any unused credit. What If I Am an Entity Exempt from Adjusted Gross Income Tax? Entities exempt from adjusted gross income tax under IC 6-3-2-2.8(2) may “pass through” the credit to shareholders, partners, or members of the pass-through entity. A pass-through entity means an S corporation, partnership, limited liability company, or limited liability partnership. Each member’s tax credit is calculated by multiplying the total credit available by the percentage of the entity’s distributive income to which the shareholder, partner, or member is entitled. Section D - Retail Sale of Blended Biodiesel Credit Note: Only blended biodiesel sold to an end user in Indiana is eligible for the credit. The $1 million cap for this credit has been reached and is no longer available. 1. Enter the total gallons of blended biodiesel dispensed at retail to an end user in Indiana. The pro rata share of the approved credit is reported by the entity on each unit holder’s Schedule IN K-1. Enclose with the return a copy of Form BD-100 or IN K-1 when claiming your share of the credit. See Income Tax Information Bulletin #91 for more information. American LegalNet, Inc. www.FormsWorkFlow.com