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Missouri Form 135.258 - New/expanded Business Facility & Enterprise Zone Tax Benefit Letter Of Intent - Department Of Economic Development

MISSOURI FORM

NEW/EXPANDED BUSINESS FACILITY & ENTERPRISE ZONE

135.258

TAX BENEFIT LETTER OF INTENT

Effective January 1, 1999, this form must be completed by all taxpayers planning to initially qualify a facility for the

new/expanded business facility or enterprise zone income tax benefits. This form must be postmarked no later than

15 days before commencement of commercial operations at the development, and must be approved by the

department before the taxpayer will be eligible to apply for these tax benefits. This form must be filed each time a

facility may be eligible to begin a new tax benefit/credit period.

FOR CALENDAR YEAR ________

OR TAX YEAR BEGINNING ____________________

ENDING ____________________

NAME OF FACILITY

FACILITY FEDERAL I.D. NO.

AND

PLEASE

MISSOURI ADDRESS OF FACILITY (WHERE DEVELOPMENT OCCURRED)

TAXPAYER FEDERAL I.D. NO.

TYPE

AND

CITY

COUNTY

ZIP CODE FACILITY MISSOURI TAX I.D. NO. (MITS)

1. IS THIS ADDRESS WITHIN A DESIGNATED ENTERPRISE ZONE?

YES

2. TAXPAYER’S NAME

MAILING ADDRESS IF DIFFERENT THAN ABOVE (STREET, P.O. BOX, CITY, STATE, ZIP CODE)

3. NAME OF PERSON COMPLETING APPLICATION

TELEPHONE NUMBER

ADDRESS OF PERSON COMPLETING APPLICATION (STREET, P.O. BOX, CITY, STATE, ZIP CODE)

4. DESCRIBE THE BUSINESS ACTIVITY(IES) TO BE CONDUCTED AT THIS FACILITY. YOU MUST BE SPECIFIC IN ORDER TO DETERMINE ELIGIBILITY.

4A. ENTER THE FACILITY’S 4-DIGIT STANDARD INDUSTRIAL CLASSIFICATION (SIC) OR 5-DIGIT NAICS NUMBER IF KNOWN

5. DESCRIBE THE DEVELOPMENT. FOR INSTANCE, “THIS IS THE EXPANSION OF AN EXISTING MANUFACTURING FACILITY. LEASEHOLD IMPROVEMENTS WERE STARTED ON JANUARY 1, 2002,

AND ARE EXPECTED TO BE COMPLETED, WITH THE NEW PRODUCTION LINE IN OPERATION IN JUNE, 2002 (THE DEVELOPMENT’S COMMENCEMENT OF COMMERCIAL OPERATIONS).

6. ENTER THE DATE THE TAXPAYER EXPECTS THE DEVELOPMENT TO BE IN OPERATION (MONTH/DAY/YEAR)

UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE EXAMINED THIS APPLICATION, INCLUDING ACCOMPANYING

ATTACHMENTS AND STATEMENTS, AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, THEY ARE TRUE, CORRECT AND

COMPLETE.

TAXPAYER’S OR DESIGNEE’S SIGNATURE & TITLE

DATE

PREPARER’S SIGNATURE

DATE

MO 419-2359 (12-01)

MAIL ALL APPLICATIONS AND ALL RELATED INQUIRIES TO: INCENTIVES SECTION, PO BOX 118, JEFFERSON CITY, MO 65102

Missouri Form 135.258 - New/expanded Business Facility & Enterprise Zone Tax Benefit Letter Of Intent - Department Of Economic Development

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