Affidavit To Support The San Francisco Enterprise Zone Tax Credit

Affidavit To Support The San Francisco Enterprise Zone Tax Credit - 2007

AFFIDAVIT TO SUPPORT THE SAN FRANCISCO

ENTERPRISE ZONE TAX CREDIT

YEAR 2007

*Business Tax ID No.: ________________________

Certificate No.:_______________

1. My fixed place of business is located within the San Francisco Enterprise Zone at the

following address:

2. On or after January 1, 1992, I created ______ (indicate #) new jobs within the San Francisco

Enterprise Zone areas.

3. On or after January 1, 1992, I hired ______ (indicate #) new employees to fill the new jobs

created within the Enterprise Zone.

All of these employees qualify as economically

disadvantaged and have participated in one of the following programs:

Workforce Investment Act (WIA) (formerly Federal Job Training Partnership Act)

Greater Avenues for Independence (GAIN) Program

Work Opportunity Tax Credit (WOTC)

County Adult Assistance Program (CAAP) (formerly known as General Assistance)

4. I understand that the facts supporting my application for the Enterprise Zone Tax Credit, as

set forth on this Affidavit and on the attached worksheet, are subject to audit by the San

Francisco Tax Collector.

Under the laws of the State of California, I declare under penalty of perjury that I have read

the foregoing and that it is true, correct, and complete to the best of my knowledge and

belief.

Signed:

Date:_____/_____/_____

Print Name:

Title:

Business Phone: (

)

* Refer to the upper left corner of your annual Payroll Tax Statement.

2007 EZ Affidavit

Rev. 10/23/07

Affidavit To Support The San Francisco Enterprise Zone Tax Credit - 2007