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Application For Tax Credit For Contribution To A Community Development Corporation Form - City Of Philadelphia Department Of Revenue Page 5

QUALIFYING COMMUNITY DEVELOPMENT CORPORATION (“QCDC”)’S

CERTIFICATION OF COMPLIANCE WITH ALL FEDERAL, STATE, AND CITY

LAWS, ORDINANCES, AND RESOLUTIONS

AND

CERTIFICATION OF NON-INDEBTEDNESS TO THE CITY OF PHILADELPHIA

The QCDC hereby certifies and represents to the City of Philadelphia that the QCDC and the

QCDC’s parent company(ies) and subsidiary(ies) are currently in compliance and shall remain in

compliance with all Federal, State, and City laws, ordinances, and resolutions.

In addition, the QCDC hereby certifies and represents to the City of Philadelphia that the

QCDC and the QCDC’s parent company(ies) and subsidiary(ies) are not currently indebted to the City

for any delinquent taxes, and shall not at any time during the term of the Tax Credit Program be

indebted to the City for or on account of any delinquent taxes (including, but not limited to, taxes

collected by the City on behalf of the School District of Philadelphia), liens, judgment, fees or other

debts for which no written agreement or payment plan satisfactory to the City has been established.

If the QCDC or the QCDC’s parent company(ies) and subsidiary(ies) are determined to be in

violation of said laws, ordinances, and regulations, the City may disqualify the QCDC from the Tax

Credit Program.

Name of QCDC

By:

Authorized Signatory

Title:

President or Vice President

Print Name

Attest:

Secretary or Treasurer

Print Name

Application For Tax Credit For Contribution To A Community Development Corporation Form - City Of Philadelphia Department Of Revenue Page 5