Certification Application Long-Term Rural Oregon Tax Incentive Form Page 2
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COMMITMENTS BY APPLICANT/BUSINESS FIRM
All must be checked below to be certified—
By the end of the calendar year in which the facility is placed in service, the total costs of property and improvements are, or will be
more than the lesser of: (a) $25 million or $12,.5 million, whichever applies; or (b) a figure equal to one percent or one-half of one
percent, whichever applies, of the value of all nonexempt taxable property in the county, rounded to the nearest $10 million of such
value, or more than $200 million.
Within the applicable time frame after operation of the facility begins, at least 10, 35, 50, or 75 new employees (whichever applies)
will be employed at the facility, in addition to persons employed by the firm within the state 12 months prior to when operations
began, and who are each working more than 32 hours per week at the facility.
Not later than the fifth year after the year in which operation of the facility begins, the average of annualized compensation or all
employees at the facility will be equal to or greater than 150 percent of the county average annual wage, as reported by the Oregon
Business Development Department, at the time that this requirement is initially fulfilled.
All additional requirements or conditions contained in the attached written agreement with the sponsor of the enterprise zone will be
satisfied (see #2 below).
Information and appropriate verification, including, but not limited to, actual levels of investment cost, employment, payroll, etc.,
that pertain to the above commitments will be presented in writing to the local zone manager and county assessor on or before the
mandatory time as noted above or as contained in applicable law and rules, or upon request by state or local officials.
DECLARATION
I declare under penalties of false swearing [ORS 305.990(4)] that I have examined this document and attachments, and to the best of
my knowledge they are true, correct, and complete. If any information changes I will notify the enterprise zone manager and the county
assessor and submit appropriate written amendments. I understand that my business firm will receive the property tax exemption for
property in the enterprise zone, only if the relevant requirements are satisfied and maintained, and if my firm complies with all local,
state, and federal laws that are applicable to my business.
Signature of Authorized Representative of Business Firm
Date
X
Standard property tax returns must still be filed.
APPROVAL
To be filled in by the local zone manager and the county assessor after the above commitments are completed.
The board of county commissioners adopted a resolution approving the property tax
Date
exemption for the facility. (Attach a copy of the resolution and indicate the date of
adoption in the box to the right.)
1
Date
The city council adopted a resolution approving the property tax exemption for the
facility, if it is located within corporate limits. (Attach a copy of the resolution and indicate
the date of adoption in the box to the right.)
Date
The business firm has entered into a common written agreement with all of the city or
county governments that sponsor the enterprise zone, including co-sponsors in addition
2
to those adopting resolutions in #1 above. (Attach a copy of the agreement and indicate
the date the agreement was concluded in the box to the right.)
Date
At the time the written agreement in #2 above was executed, the facility was located
in an existing rural enterprise zone and in a county with chronically low income or
3
unemployment. (Attach confirmation from Oregon Business Development Department
that the zone is not terminated and that relevant county or U.S. economic statistics
satisfy requisite legal definitions. Indicate the date of the letter and the length of the
exemption period in the box to the right.)
Signature of Local Enterprise Zone Manager
Date
X
Signature of County Assessor
Date
X
Zone Manager/County Assessor: After signing, send copies of this form and all attachments to:
(1) Business firm; (2) Oregon Department of Revenue; (3) Oregon Business Development Department
150-310-073 (Rev. 10-10)
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