Kentucky Notice of ENDOW Kentucky Tax Credit and Certification KRS 141.438

Notice of ENDOW Kentucky Tax Credit and Certification KRS 141.438
Schedule ENDOW
SCHEDULE

ENDOW

NOTICE OF ENDOW KENTUCKY TAX
CREDIT AND CERTIFICATION

Commonwealth of Kentucky
Department of Revenue

2023

 See instructions.
 Attach to Form 720, 720U, PTE, 725, 740, 740-NP, or 741

A	 Name of Taxpayer	

B	 Federal Identification Number or	

C	 Kentucky Corporation/LLET

Street Address or P. O. Box 	

	

Telephone

City
	 	 	

State
	 	

	

	 	

Social Security Number	

D	 Type of Entity: 	

¨  Individual	

			

¨  General Partnership	

¨  Estate	

Date the Endowment Gift was made to the Approved	
Foundation	

M M

D D

	
ZIP Code

¨  Trust	

¨  Corporation	

E-mail Contact

¨  Limited Liability Pass-through Entity

¨  Other

E	

 /     /

Account Number (if applicable)

F	
	

Amount of Endowment Gift	
	

Y Y

G	 Date of the Department’s

Preliminary Authorization of Credit

M M

 /     /

H	 Name of Qualified Community Foundation	

I	

Federal Identification Number	

Telephone

	

	

	

Fax Number

Street Address or P. O. Box	

	

	

City

State

or Affiliate Community Foundation
	 	

D D

Y Y

ZIP Code

J	 If applicable, name of Permanent Endowment Fund or County-Specific Component Fund receiving the gift

	 Under penalties of perjury, I declare that the Foundation is a qualified community foundation as provided by KRS 147A.310(6);
that the endowment gift listed above is held in a permanent endowment as provided by KRS 147A.310(4); and that I have
examined this schedule, including all accompanying documents and statements, and to the best of my knowledge and belief,
it is true, correct, and complete.
	

By:  __________________________________________ 	

Date: _________________________________________

	

Print Name:  ___________________________________ 	

Title:  ________________________________________

	

	

Signature of Foundation Officer (or designee)	

	

	

Department of Revenue Use Only
Endow Kentucky tax credit approved by the Department of Revenue.
	 	

Amount

By:  _______________________________________ 	 Date:  ___________________

230330 41A720-S86 (3-23)	

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SCHEDULE ENDOW
(2023)

INSTRUCTIONS—NOTICE OF ENDOW KENTUCKY TAX CREDIT AND CERTIFICATION

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The process for finalizing the endowment gift after preliminary authorization is received is set forth in 103 KAR 15:195
Section 4. All questions should be directed to:  [email protected].
A taxpayer must attach a copy of the approved Schedule ENDOW to the tax return each year to claim the tax credit against the
taxes imposed by KRS 141.020 or 141.040 and 141.0401. The ordering of the credits must be as provided by KRS 141.0205.
A partner, member, or shareholder of a pass–through entity must attach a copy of Schedule K-1, Form PTE to the partner’s,
member’s, or shareholder’s tax return each year to claim the tax credit.
A beneficiary of an estate or trust must attach a copy of Schedule K-1, Form 741, to the beneficiary’s tax return each year
to claim the tax credit.

Submission Instructions
Choose one of the following options to submit the Endow application.
		 E-mail:	 [email protected]
		 Fax:	 502-564-0058
	
Hand–delivery:	 Department of Revenue, 1st floor security desk at 501 High Street, Frankfort, Kentucky (call
502-564-8139 and ask for an employee in the Tax Credits Section.)

Note:	

This application contains time-sensitive information; therefore, mailing the application is not
recommended.

41A720-S86 (3-23)