A maternity home operator that seeks to claim a tax credit under IC 6-3.1-14 for operating a maternity home that is registered under this chapter shall file with the state department a form provided by the state department certifying the following information:

1. (1) The tax credit the maternity home operator desires to claim for the taxable year.

2. (2) Information on each pregnant woman claimed, including the following:

   1. (A) Name.
   2. (B) Last known address.
   3. (C) Dates resided with maternity home operator.
   4. (D) Current status of pregnancy.

   5. (E) Date or expected date of delivery.

      [Pre-1993 Recodification Citation: 16-2.5-2-4.]

As added by P.L.2-1993, SEC.9.