City of Philadelphia
FOR DEPARTMENT USE ONLY
Application No. __________________
Department of Revenue
Date Received _______________ ___
Time Received _______________ ___
APPLICATION FOR TAX CREDIT FOR CONTRIBUTION TO A COMMUNITY DEVELOPMENT
CORPORATION
(SECTION 19-2604 OF THE PHILADELPHIA CODE)
SECTION I
Applicant/Sponsor
1. Applicant’s Name
2. Address
3. Contact Person
4. Telephone Number
5. Business Privilege Tax Year
6. BPT Account Number
7. Federal Employee Identification
8. Date Philadelphia Business Began
Number/Social Security Number
SECTION II
Community Development Corporation
1. Name of Community Development Corporation
2. Address
3. Contact Person and Title
4. Telephone Number
5. Geographic Boundaries of Target Area
6. Federal Employee Identification Number
7. City Council District(s)
1