Form 89c - Certification For Idaho'S Administrative Facilities Tax Incentives
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1
289C
CERTIFICATION FOR IDAHO'S
F
O
R
ADMINISTRATIVE FACILITIES TAX INCENTIVES
EFO00007
M
11-21-05
Federal employer identification number
Business name
Business mailing address
Contact person and title
City, state and zip code
Telephone number of contact person
Type of qualifying incentives (check only one box). See instructions for more information on the tax incentive criteria that must be
met to qualify.
Incentives allowed by Idaho Small Employer Incentive Act of 2005 — capital investment in new headquarters or administra-
tive facilities of at least $500,000 at the project site, increased employment at the project site by at least ten new employees,
and increased employment of at least one new employee for each $50,000 invested in new headquarters or administrative
facilities.
Incentives allowed by Idaho Corporate Headquarters Incentive Act of 2005 — capital investment in new headquarters or
administrative facilities of at least $50 million at the project site, and increased employment at the project site by at least 500
new employees.
The following information is required to certify that the proposed project will meet the tax incentive criteria during the project period.
Failure to provide the requested information may result in the Tax Commission denying any tax incentives claimed under the Idaho
Corporate Headquarters Incentive Act or the Idaho Small Employer Incentive Act.
1.
Description of qualifying project
2.
Estimated/actual start date of project. The start date is the earlier of the date the first physical change to the project site is
scheduled to occur or the date new employees related to the project site will be first employed in Idaho. The start date cannot
be earlier than January 1, 2005.
3.
Estimated/actual end date of project. This cannot be later than December 31, 2009.
4.
Location of the project site(s). Identify the street address for each site. If more than one location, identify the percent of the
investment projected at each site once the project is completed.
5.
If claiming the incentives under the Corporate Headquarters Incentive Act, is this the location of the company's national or
regional headquarters?
Yes _______ No _______ If no, please explain.
%
6.
Estimated/actual percent of company's administrative services handled at the project site(s)
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