Form It-Hq - Application For Georgia Headquarters Job Tax Credit Page 2
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5IT-HQ
(REV 4/02)
B. CURRENT FINANCIAL INFORMATION:
1. Nature of business ____________________________________________________________
2. NAICS Code (six digit level)______________________________________________________
3. Describe the product(s) produced or service(s) provided________________________________
4. County / Tier _________________/_____________________
5. Projected payroll expense including benefits (annual)______________________________________
6. Projected number of new jobs created after completion of the Headquarters project and estimated time frame.
Estimated timeframe
Estimated new jobs created by year, if applicable
Year 1)________
Year 2)
Year 3)
Year 4)
Year 5)
Year 6)
Year 7)
7. Average weekly employee wage (of new jobs)________________________________________
8. Average wage of the County/ Tax Year: ___________________/______________
9. Percentage above County Average Wage: ________________________________________
10. Total payroll expense including benefits (of new jobs)_________________________________
11. Legal Representative of Company. (If authorized to represent the Company, please include power of attorney.)
_________________________________________________
(Firm)
_________________________________________________
(Contact Name)
_________________________________________________
(Address)
_________________________________________________
(City)
(State)
(Zip)
_________________________________________________
(000) 000-0000
(Phone Number)
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Parent category: Financial