WERE YOU DISCHARGED, RETIRED OR SEPARATED FROM SERVICE BECAUSE OF DISABILITY OR DO YOU NOW HAVE ANY SERVICE-CONNECTED DISABILITIES?
YES NO VA CLAIM FILE NUMBER PREVIOUS VA LOANS
Investment Credit Form 3468 fields Identifying number Check this box if you are electing under section 47(d)(5) to take your qualified rehabilitation expenditures into account for the tax year in which paid (or, for self-rehabilitated property, when capitalized). See instructions. Note: This election applies to the current tax year and to all later tax years. You may not revoke this election without IRS consent date on which the 24- or 60-month measuring period begins date on which the 24- or 60-month measuring period ends adjusted basis of the building as of the beginning date above (or the first day of your holding period, if later) amount of the qualified rehabilitation expenditures incurred, or treated as incurred, during the period specified above Enter the amount of qualified rehabilitation expenditures Pre-1936 buildings located in the Gulf Opportunity Zone Other pre-1936 buildings Certified historic structures located in the Gulf Opportunity Zone Other certified historic structures assigned NPS project number or the pass-through entity's employer identification number (see instructions) date that the NPS approved the Request for Certification of Completed Work Rehabilitation credit from an electing large partnership (Schedule K-1 (Form 1065-B), box 9) Energy Credit Basis of property using geothermal energy placed in service during the tax year Basis of property using solar illumination or solar energy placed in service during the tax year Qualified fuel cell property Basis of property installed during the tax year Kilowatt capacity of property specified above Qualified microturbine property Basis of property installed during the tax year Kilowatt capacity of propertyspecified above Qualifying advanced coal project credit Basis of qualified investment in integrated gasification combined cycle property placed in service during the tax year Basis of qualified investment in property other than in specified above placed in service during the tax year Qualifying gasification project credit. Basis of qualified investment in property placed in service during the tax year Credit from cooperatives. Enter the unused investment credit from cooperatives
APS Solar Partners Incentive APS Account Number Installation Address Are you a Dealer or Manufacturer of PV Systems, or an employee of a Dealer or Manufacturer? Yes No Will customer own the PV system? Yes No SYSTEM INFORMATION Estimated Installation Date
PV Module Manufacturer Model # UL Listing
Inverter Manufacturer Model # UL Listing Equipment conforms to IEEE 929 standard Yes No Total Watts (PV Module DC Watts W-STC Rating) EQUIPMENT DEALER INFORMATION Contact Name Telephone Fax Email Mailing Address INSTALLER INFORMATION (If same as equipment dealer, check here ) Contact Name Telephone Fax Email Mailing Address Arizona Registrar of Contractors (AZROC) License Information Number Class Expiration INCENTIVE REQUEST Incentive Level DC Watts STC Total Incentive Will payment be assigned to an installer, dealer or manufacturer of the qualifying solar system? Yes No Name and Address for 3rd Party Payment (if applicable)
