Minnesota JOBZ Motor Vehicle Purchase Report (Revised 7/09)

JOBZ Motor Vehicle Purchase Report (Revised 7/09)
2016 M500, Reporting of JOBZ Tax Benefits for Tax Year
2016 Form M500, JOBZ Tax Benefit Report
Use this form to report the sales tax incentives the qualified business received for participating in a Job Opportunity Building Zone (JOBZ).
Name of qualified business			

Taxpayer name (if different from JOBZ business) 	

JOBZ ID number

Business address in the zone				

FEIN

City	

Minnesota tax ID number

State	

Zip code	

County	

MN
	
Taxpayer: 	

C-Corporation	

S-Corporation	

Partnership	

Individual	

Fiduciary	

Other (specify):	

Business contact’s name (first, last)	

Title	

Daytime phone

Email address of qualified business (optional)	

Primary parcel ID (if more than one, attach a sheet)

	

Zone Tax Benefits

	1	 Did you receive any zone tax benefits in 2016?
		
		

	Yes. Continue with line 2.
	No. Explain your situation below, sign at the bottom and file this form by the due date:

Sales Tax Exemptions
	2	 Purchases you made in 2016 of tangible personal property (not including capital equipment
		 or purchases exempt as a part of product production cost) and services primarily used or
		 consumed in the zone that would otherwise have been taxable  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  2	
	3	 Purchases you and/or your contractor made in 2016 of construction materials and supplies
		 used to construct or improve real property used by the qualified business in the zone  . . . . . . . . . . . . . . . . . . . . . . . . . . .  3	
	4	 Purchases made in 2016 of motor vehicles that are principally garaged
		 in the zone and primarily used to carry out your zone operations
		 (enter each vehicle’s VIN number and purchase price; if you have more than 4 vehicles,
		 complete Form M500A, JOBZ Motor Vehicle Purchase Report - see instructions)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  4	
		VIN
		VIN

	 $
	 $

	
	

VIN
VIN

	 $
	 $

	5	 Is the qualified business located in an area with			
		 a local sales and use tax (see instructions)? 	
5 No	
Yes	

Enter
the area:

	I declare that this report is correct and complete to the best of my knowledge and belief.
Signature of authorized representative of qualified business	

Date	

Do not include Form M500 with your tax return.
By October 15, 2017, mail this form and a copy of your Schedule JOBZ, if any, to: 	
		
		
		
		

Minnesota Revenue
Mail Station 6330
St. Paul, MN 55146-6330
Phone: 651-556-6836
Fax: 651-556-3102

	
	

Form M500 Instructions
Important News
If you are a qualified business, failure to
submit Form M500 will result in removal
from the JOBZ program. You will also be
subject to repayment of prior JOBZ tax
benefits received.
If you are a qualified business, you must
file Form M500 with the Department of
Revenue no later than October 15, 2017.
This form is used to report sales and use
tax benefits you received for participating
in a Job Opportunity Building Zone (JOBZ)
for tax year 2016. All qualified businesses
should file Form M500, even if there are no
tax benefits to report.

Lines 2–5

Complete lines 2 through 5 if you (or, in
some cases, your contractor) made purchases in 2016 that were exempt from state and
local sales taxes for participating in a zone.

Line 2

Enter your purchases of taxable goods and
services that were primarily used or consumed during the year in the zone.
Do Not Include:
•	

purchases of capital equipment where
you have received, or expect to receive, a refund of sales or use tax,

•	

purchases of motor vehicles or construction materials and supplies, or

This form is in addition to any other reporting requirements with the Department of
Revenue, the zone administrator or the
Department of Employment and Economic
Development (DEED).

•	

product production purchases such as
raw materials and utilities. Materials
and utilities used or consumed in producing products for resale are already
exempt.

Qualified Business

Line 3

You are a qualified business if your place of
business is located within a JOBZ zone and
you have signed a Business Subsidy Agreement with the zone administrator.

Enter the purchases made by you, or a
contractor or subcontractor, of construction
materials and supplies used to construct improvements to real property used during the
year by the qualified business in the zone.

County and Parcel ID Number

Ask your contractor for his or her purchasing information.

Enter the county in which the qualified
business is located.
Enter the property’s primary parcel ID or
property ID number assigned to it by the
county. You can find the parcel or property
ID number on the property tax statement.
Attach a sheet with additional parcel
numbers if more than one number is located
within the zone.

Email Address
If the department has questions regarding
your Form M500 and you want to receive
correspondence electronically, be sure to
provide your email address.

Line Instructions
Line 1

Check the appropriate box to indicate if you
received any tax benefits for participating in
a zone during the year.
If you did not receive any tax benefits, explain your situation, sign and file the form.

Line 4

A motor vehicle purchased by a qualified
business is exempt if the motor vehicle is
principally garaged in the zone and is primarily used as part of, or in direct support
of, the business’s operations carried on in
the zone.
Enter the Vehicle Identification Number
(VIN) and purchase price under line 4. If
more than four vehicles are used, complete Form M500A, JOBZ Motor Vehicle
Purchase Report. Enter additional VINs/
amounts of purchase on the form and send
with Form M500.

Line 5

If the qualified business is located in an
area with a local sales and use tax (see the
following list, be sure to enter the area on
the line provided.

Local Sales and Use Tax Areas:
Albert Lea	
Austin	
Baxter	
Becker County	
Bemidji	
Beltrami County	
Blue Earth County	
Brainerd	
Brown County	
Carlton County 	
Cass County	
Chisago county	
Clearwater	
Cloquet	
Cook County	
Crow Wing County	
Douglas County	
Duluth	
Fergus Falls	
Fillmore County	
Freeborn County	
Hermantown	

Hubbard County
Hutchinson
Lanesboro
Lyon County
Mankato
Marshall
Medford
New Ulm
North Mankato
Olmsted County
Otter Tail County
Proctor
Rice County
Rochester
St. Cloud Area
St. Louis County
Steele County
Todd County
Two Harbors
Wabasha County
Wadena County
Worthington

For complete information, see Sales and
Use Tax Fact Sheet 164, Local Sales and
Use Taxes.

Signature

An authorized representative of the qualified business must sign and date the form.

Where to File

By October 15, 2017, mail Form M500,
along with a copy of Schedule JOBZ, to:
	
Minnesota Revenue
	
Mail Station 6330
	
St. Paul, MN 55146-6330
or fax to: 651-556-3102
Do not submit Form M500 with your tax
return.

Use of Information

All information provided on Form M500 is
nonpublic and cannot be disclosed to others
without your consent.
The information will be used to administer
the JOBZ program, however, and may be
shared with other state agencies, to the extent necessary to administer the JOBZ laws.

Questions or Need Forms?

You can find forms and the most current information on our website at
www.revenue.state.mn.us.
If you have questions, call 651-556-6836
during business hours.
This information is available in alternate
formats.