Form 150-303-029 - Oregon Enterprise Zone Precertification Application
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1
2OREGON ENTERPRISE ZONE PRECERTIFICATION APPLICATION
• Complete form and submit to the local enterprise zone manager before breaking ground or beginning work at the site. • Please type or print neatly.
APPLICANT
Enterprise Zone (where business firm and property will be located)
County
Name of Business Firm
Telephone Number
(
)
Mailing Address
City
State
ZIP Code
Location of Property (street address if different from above)
City
State
ZIP Code
Map and Tax Lot No. of Site
Contact Person
Title
My firm expects to apply for this property tax exemption in the following year(s):
Check here if you have, or have had, other exemptions in this enterprise zone. Give the first year(s) of the exemptions you have
received, are receiving, or expect to receive:
ELIGIBILITY
Eligible Activity —
Check all activities that apply within the enterprise zone:
Manufacturing
Fabrication
Shipping
Assembly
Processing
Storage
Other — describe the activities that provide goods, products or services to other businesses (or to other operations of your firm):
Check here if your business firm engages in ineligible activities (such as retail sales, health care or construction). Describe below
(or in an attachment) these activities and how they are physically separate from “eligible” activities checked above:
Check here if a hotel, motel or destination resort in an applicable enterprise zone.
Check here if a retail/financial call center. Indicate expected percent of customers in local calling area:
%
Check here if a “headquarters” facility. (Zone sponsor must find that operations are generally not local and are significant.)
EMPLOYMENT
Do not count temporary, seasonal, construction, FTE or part-time jobs (32 hours or less per week), or employees working at ineligible operations.
New Employees —
• Hiring is expected to begin on
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(date or month and year)
• Hiring is expected to be completed by
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(month and year)
• Estimated total number of new employees to be hired with this investment is . . . . . . . . . . . . . . .
First-Source Hiring Agreement —
Check here that your firm is entering into this agreement before hiring new eligible employees. (This mandatory agreement entails
an obligation to consider referrals from local job training providers for openings within the zone.)
Commitments —
By checking both boxes below you agree to the following commitments as required by law for precertification:
I will hire one or more new employees in the zone on or before April 1 of the first year of exemption, and I will not substantially
curtail employment within the zone during the exemption period; and
By April 1 of the first year of exemption I will increase existing employment within the zone by 110 percent, and I will maintain at
least that level as an annual average during the exemption period.
My firm’s average annual employment within the zone over the 12 months prior to precertification was ____ existing jobs.*
Jobs Outside of the Enterprise Zone —
Check any that apply:
Check here if your firm or a commonly controlled firm is, or will be, closing or curtailing operations in the state beyond 30 miles of
the zone’s boundary. If any operations are transferred to the zone, indicate timing, county and number of any job losses:
Check here if you are moving any operations into the zone from site(s) within 30 miles of the boundary (existing businesses only):
• My firm’s average annual employment within the zone and at the site(s) for the 12 months prior to precertification was ___________ existing jobs.*
• My firm’s total employment within the zone and 30 miles thereof by April 1 of the initial year of exemption will be ____________ jobs.
(estimate)
150-303-029 (Rev. 11-99)
*
See page 3—Worksheet for Calculating Existing Jobs.
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