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Employment Information

Audit Records Location

16. Average Number of Full Time Equivalents (FTEs) for

If your application is approved, a deferral certificate will

Previous Calendar Year.

be issued using the estimates from your application.

(1820 annualized hours worked = 1 FTE):

Upon completion of the project, an auditor will verify

that you are performing qualified activities at this

Entire Business:

facility. They will also verify that the approved

At This Facility:

percentage of your structure and 100% of the machinery

and equipment are eligible for the deferral. The auditor

17. Estimated Number of New FTEs as

may adjust the allowable deferral based on his or her

a result of this project:

findings.

If your investment project is located in a rural county, please

To minimize inconvenience and the time it takes to

skip question 18.

complete an audit, please have the following records for

18. If your investment project is located in a community

the audit period available for your meeting with the

empowerment zone (CEZ) or a county containing a CEZ,

auditor:

you must hire a least one qualified employment position

•

Purchase invoices (i.e., accounts payable, receipts)

for each $750,000 of investment on which a deferral is

approved. The persons must be hired after the date the

•

Supporting documentation for the construction,

application is filed with the department. Each qualified

such as construction contracts

employment position must be filled by persons who at the

•

Original Sales and Use Tax Deferral Certificate

time of hire are residents of the CEZ. If, by the end of the

second calendar year following the year in which the

project is certified as operationally complete, you have

Although most audits can be completed with the above

not hired and retained for twelve calendar months the

records, additional documents may be required during

required number of qualified employment positions, all

the audit.

deferred taxes are immediately due.

Please complete the following information about the

Estimated number of qualified full-

contact person and audit records location if this

time positions that will be filled by

information is currently available:

residents of the CEZ:

Name of CEZ:

21. Contact person:

Use of Facility

22. Phone number of contact person:

All businesses must maintain a qualified activity at the site of

the investment project for the year in which the investment

project is certified as operationally complete, plus seven

23. Location of audit records

additional years.

Yes

19. Do you plan to operate this investment

project in a qualified manner for 8

years from the time the project is

complete?

20. If the answer to question 19 is “No”,

how long do you plan to operate this

Applicant’s Signature

Date

investment project with qualified

use?

Title

If the manufacturing or research and development activity is

not maintained, all or a portion of the deferred taxes

outstanding for this investment will be immediately due. The

department will assess interest at the rate provided for

delinquent excise taxes, but not penalties, retroactively to the

date of the deferral.

For tax assistance, visit dor.wa.gov or call 1-800-647-7706. To inquire about the availability of this document in an alternate format for

the visually impaired, please call (360) 705-6717. Teletype (TTY) users please call 1-800-451-7985.

REV 81 1002-3 (07/08/09)

Form Rev 81 1002-1 - Rural County Application For Sales And Use Tax Deferral 82.60 Rcw Page 3

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