Form Or-Ap-Cert - Oregon Enterprise Zone Certification Application

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Oregon Enterprise Zone Certification Application
Form
Long-Term Rural Tax Incentive
OR-AP-CERT
ORS 285C.400–285C.420
• Complete this form and submit to the local enterprise zone manager and the county assessor before breaking ground or beginning work at the site.
Eligible location
(see #3 on the back)
County
Rural enterprise zone
Applicant
Phone
Name of business firm
(
)
City
State
ZIP code
Mailing address
City
State
ZIP code
Location of property (street address if different from above)
Title
Map and tax lot number of site
Contact person
Defining the facility
Description of proposed operations and facility: (attach additional pages)
Facility property or improvements to be purchased, constructed, or installed:
Square footage/acreage/
Type of property
Estimated cost
number of units or items
Buildings, structures and land
$
Real
Additions/modifications to
$
property
existing buildings and structures
Machinery and equipment attached to the
$
building
Machinery and equipment that is readily movable
$
Personal
property
Other tangible personal property
$
Total estimated cost of new investment
$
Assessed value of all property currently at the site of the
To be acquired by applicant
$
proposed facility/investment (not subject to the exemption)
$
Applicant already owns/leases
Construction, hiring, and commencing operations:
• Construction is expected to begin ..................................................................................................................
___________________
• Hiring is expected to begin (month/year) .......................................................................................................
___________________
• Facility is expected to be first placed in service/operations beginning (month/year) .....................................
___________________
• Final construction of facility property is expected to be completed (month/year) ..........................................
___________________
• Hiring is expected to be completed (month/year) ..........................................................................................
___________________
• Estimated total of full-time employees to be hired by the firm for new facility................................................
___________________
Corporate excise tax credits
Will applicant seek the 5 to 15-year tax credit under ORS 317.124?
Yes*
No
* Must be approved, in writing, by the governor of the state of Oregon and begin no later than the third calendar year after the year in which the facility is
placed in service. It’s not sought until after certification. The facility must be owned by a corporation.
150-310-073 (Rev. 10-17)

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