Npa Final - Form 2 - Department Of Economic Development
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4NPA Final – Form
2
LOG NUMBER
NEIGHBORHOOD PRESERVATION ACT TAX CREDIT PROGRAM
FINAL APPROVAL FORM – FORM 2
1a. APPLICANT INFORMATION (PERSON OR ENTITY CLAIMING THE TAX CREDIT)
NAME OF INDIVIDUAL OR ENTITY
1b. TYPE OF ENTITY
IF APPLICANT IS A BUSINESS ENTITY:
IF APPLICANT IS AN INDIVIDUAL TAXPAYER:
Partnership
Corporation
Property Owner
General
Limited
Regular
Subchapter
Other (specify)
Trust
LLC
__________________________________________
NAME OF AUTHORIZED COMPANY
TITLE
MAILING ADDRESS
OFFICIAL
BUSINESS ADDRESS
CITY/TOWN
CITY/TOWN
STATE
ZIP CODE STATE
ZIP CODE
TELEPHONE
FAX
TELEPHONE
FAX
TAXPAYER IDENTIFICATION NUMBER (OR SOCIAL
SOCIAL SECURITY NUMBER
SECURITY NUMBER)
NAICS CODE (See Definitions in Guidelines)
SPOUSE SOCIAL SECURITY NUMBER (if applicable)
EMAIL ADDRESS
EMAIL ADDRESS
ARE YOU THE PROPERTY OWNER? IF NOT, PLEASE LIST
ARE YOU THE PROPERTY OWNER? IF NOT, PLEASE LIST
OWNER
OWNER
2. PROJECT CONTACT
Applicant
Owner
Other (Consultant, etc.)
NAME
ADDRESS
CITY/TOWN
STATE
ZIP CODE
EMAIL
TELEPHONE
FAX
3. PROPERTY INFORMATION
ADDRESS
CITY/TOWN
STATE
ZIP CODE
COUNTY
4. OWNER INFORMATION (IF PROPERTY HAS BEEN SOLD)
ADDRESS
CITY/TOWN
STATE
ZIP CODE
PHONE
FAX
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Parent category: Financial