Form Reg-19 Low And Moderate Income Housing Facilities Application For A Facility Approval Letter printable pdf download

Department of Revenue Services

REG-19

State of Connecticut

25 Sigourney Street

Low and Moderate Income Housing Facilities

Hartford CT 06106-5032

Application for a Facility Approval Letter

(Rev. 02/02)

Statutory Authority: Conn. Gen. Stat. §12-412(29)

Purpose: Use REG-19 to apply with the Department of Revenue Services (DRS) for qualification as an exempt low and moderate

income housing facility.

1. Identification of the Facility:

Name and address of facility ____________________________________________________________________________________

Attach a description of the housing facility including the number of dwelling units, the number of units occupied by low and moderate

income persons or families, the policies instituted that ensure the facility will continue to qualify for the exemption, its location, its dates

of construction, and commencement of operation.

2. Identification of Sponsoring Organization:

Full name of the organization (as shown on organizing document)

Name and daytime telephone number of person to be contacted for information

(

)

Sponsoring organization’s address: number and street, city or town, state, and ZIP code

Date incorporated or formed

State of incorporation or formation

Organizing documents: Submit a copy of the sponsoring organization’s organizing document that states it has as one of its purposes

the development, construction, sponsorship, or ownership of housing for low and moderate income families. The copy may be a

photocopy of the signed and dated original document. (Do not send originals because all documents submitted become part of the

application file.)

Corporation:

Attach a copy of the articles of incorporation (including amendments and restatements) showing the stamp or

seal of the Secretary of the State.

Unincorporated: Attach a copy of the constitution and bylaws.

3. Identification of Operating Organization: If the operating organization is different from the sponsoring organization, provide the

information requested in addition to the full name and address of the operating organization.

Full name of the organization (as shown on organizing document)

Name and daytime telephone number of person to be contacted for information

(

)

Operating organization’s address: number and street, city or town, state, and ZIP code

Date incorporated or formed

State of incorporation or formation

Organizing documents. Submit a copy of the operating organization’s organizing document. If the operating organization is a nonprofit

housing organization, submit a copy of the organization’s organizing document that states it has as one of its purposes the development,

construction, sponsorship, or ownership of housing for low and moderate income families. The copy may be a photocopy of the signed and

dated original document. (Do not send originals because all documents submitted become part of the application file.)

Corporation:

Attach a copy of the articles of incorporation (including amendments and restatements) showing the stamp or

seal of the Secretary of the State.

Unincorporated: Attach a copy of the constitution and bylaws.

4. Identification of Owner If the owner of the housing facility is different from the sponsoring or operating organization, provide the

information requested in addition to the full name and address of the owner’s organization.

Full name of the owner (as shown on organizing document)

Name and daytime telephone number of person to be contacted for information

(

)

Owner’s address: number and street, city or town, state, and ZIP code

Date incorporated or formed

State of incorporation or formation

Continued on Reverse

Form Reg-19 Low And Moderate Income Housing Facilities Application For A Facility Approval Letter

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