City Of Philadelphia Department Of Revenue Form - Renewal Application - Application Approval - Certification Of Non-Indebtedness To The City Of Philadelphia

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FOR DEPARTMENT USE ONLY
City of Philadelphia
Application No. __________________
Department of Revenue
Date Received _______________ ___
RENEWAL APPLICATION
FOR TAX CREDIT FOR CONTRIBUTION TO A COMMUNITY DEVELOPMENT CORPORATION
(SECTION 19-2604 OF THE PHILADELPHIA CODE)
SECTION I
Applicant/Sponsor
1. Applicant’s Name
2. Address
3. Contact Person
4. Telephone Number
5. Federal Employee Identification
6. BPT Account Number
7. Date of Annual Contribution To
8. Commencement Date
Community Development Corporation
SECTION II
Community Development Corporation
1. Name of Community Development Corporation
2. Address
3. Contact Person and Title
4. Telephone Number
5. Geographic Boundaries of Target Area
6. Federal Employee Identification Number
7. City Council District(s)
1

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