Virginia Virginia Motion Picture Production Tax Credit

Virginia Motion Picture Production Tax Credit
Form MPC - Virginia Motion Picture Production Tax Credit Refund Request
Virginia
Form MPC

Virginia Motion Picture Production Tax Credit
Refund Request

Tax Year
___________

You must enclose a copy of the credit certificate issued by the Virginia Film Office within the Virginia Tourism Authority.
Reason for Submitting Form MPC:
	 You are a pass-through entity (PTE) requesting a direct refund of the Motion Picture Production Tax Credit instead of allocating
the credit to individual partners, shareholders, or members. Any refund directly paid to the PTE may not be allocated to the entity
owners.
	 You are requesting a refund of the Motion Picture Production Tax Credit when no income tax return is required by Virginia.
NOTE: If you are not registered with the Department of Taxation, you must complete Form R-1, Business Registration Form, prior to
submitting Form MPC. Visit www.tax.virginia.gov to register online or download and complete the registration application.

Section I — Credit Holder Information
Legal Entity Name

FEIN

Trade Name

Office Use Only

Street Address
City, State, ZIP Code

Contact Email Address

Contact Name

Contact Phone Number

Entity Type: (Check One)	

  Partnership	

 LLC	

Contact Fax Number

  Other _________________________

Tax year in which the credit may be claimed (mm/dd/yyyy): Start Date_______________ End Date_______________
Amount of refund requested: $________________________
Section II — Authorized Representative Information
Name

Title

Business Name

Affiliation

Street Address
City, State, ZIP Code
Phone Number

Fax Number

Email Address

Section III­— Declaration
I, the undersigned owner or authorized representative declare, under the penalties provided by law, that this form (including any
accompanying schedules, statements, and attachments) has been examined by me and is, to the best of my knowledge and belief, a
true, correct, and complete application, made in good faith pursuant to the income tax laws of the Commonwealth of Virginia. I certify
that all owners of the PTE agree to this request for the tax credit refund to be issued directly to the PTE. Additionally, I certify that any
credit amount that is refunded directly to the PTE will not be allocated to the entity owners on Virginia Schedule VK-1 or claimed on any
Virginia income tax return by any entity owner.
Signature of Owner or Authorized Representative
Printed Name

Title
Phone Number

Date

Email Address

Mail Form MPC to Virginia Department of Taxation, Tax Credit Unit, P.O. Box 715, Richmond, VA 23218-0715 or fax to
(804) 774-3902. For assistance, call (804) 786-2992.
Va. Dept. of Taxation  2604045  Rev. 03/21