Form Ppt Pcf - Application For Air, Noise Or Water Exempt Facility Page 3
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3PPT PCF
Instructions for Completing Application
Rev. 9/05
Page 3
(Failure to properly complete an application will result in the denial of the issuance of a certificate.)
1.a. Check the appropriate space for the type of exempt facility
10.b. If the facility is completed, list the completion date of the
you are requesting (Air, Noise or Water Pollution Control).
facility. If not completed, indicate the estimated completion
Unless line 1.b. of the instructions applies, a separate
date.
application must be filed for each exempt facility. This
10.c. Enter the date that construction of the facility began. If
application cannot be used for an application related to the
construction has not started, indicate the estimated start
expansion, addition or replacement of property for an existing
date.
certificate or to transfer a certificate to a new owner.
10.d. Air, noise or water pollution control facilities require Ohio
1.b. If the application is for substantially similar facilities located
EPA permits. Provide your permit number(s).
in the same county and by the same owner(s), you may
initially file one application for all those facilities. This
11.
You must include the following documents and/or
department will notify you if it is required to file separate
information as attachments for the application to be
applications for each facility in the county.
considered complete (if multiple facilities in the same county
are claimed you must note any differences in the facilities):
2.
Check the appropriate space to indicate the type of
ownership. If this facility is jointly owned, check “Joint.” File
11.a. Provide a copy of the plans, specifications and
only one application for all the owners of a facility.
drawings of the facility for which an exempt facility
certificate is requested.
3.
Print the name of the owner of the facility. If the facility for
which the application is requested is jointly owned or owned
11.b. Complete the Exempt Facility Property Listing labeled
by a partnership, you must list the names of all the owners
as “Attachment B.” All components incorporated in or
along with their respective percentage of ownership. If
to be incorporated in the facility, along with the cost of
needed, attach a list to this application.
those components, must be listed.
If auxiliary
property is claimed, you must clearly indicate the
4.
Print the mailing address of all the owner(s) of the facility. If
basis and your calculation for how you determined
needed, attach a list to this application. Note: This is the
the tax-exempt cost for the auxiliary property.
location where the issuance, or denial, of a certificate will
be mailed.
11.c. Provide a narrative statement that succinctly explains
the purpose and operations of the facility. You must
5.a. Enter the owner(s) federal employer identification number
report the operations of the facility that are both subject
(FEIN). If you are a sole proprietor and you do not have an
to a tax exemption and those operations that are not.
FEIN, you must use your social security number. If needed,
attacha list to this application.
12.
The initial application fee is ½% of the exempt facility cost
listed on line 9.a., not to exceed $2,000. The fee is not
5.b. Enter the owner(s) Ohio charter number (incorporated in
refundable. Only checks and money orders payable to the
Ohio) or license number (doing business in Ohio). If needed,
Ohio Treasurer of State are acceptable (no cash). The fee
attach a list.
may increase if the costs are higher than reported.
6.
Print the name of the facility. If needed, attach a list to this
13.
Print the name and e-mail address of the primary contact
application if this is for more than one similar facility in the
person. Note: This is the person that will be sent notice
same county.
for any additional information that is needed to have a
7.
Print the physical address of the facility. The physical
complete application and should be the person that is able
address is needed for inspection purposes. If needed, attach
to explain any questions regarding this application to this
a list to this application if this is for more than one similar
department or the Ohio EPA. If not by an employee of the
facility in the same county.
owner of the facility, a TBOR-1 is required.
8.
List the taxing district, township, school district and county
14.
Print the mailing address for the primary contact person.
where the facility is located. If needed, attach a list to this
15.
Print the telephone number and fax number of the primary
application if this is for more than one similar facility in the
contact person. If applicable, you may provide an additional
same county.
number.
9.a. Provide the total exempt facility cost. This includes costs
16.
Check the appropriate space if you want to claim the cost
that will be taxable and nontaxable if a certificate is issued.
reported on line 9.b. as exempt for certain taxes. While you
9.b. Provide the facility cost that only includes the portion of costs
may be able to file a refund claim, final assessment or tax
for which the applicant seeks a tax exemption. Note: This is
appeal for property claimed as exempt prior to filing this
the amount that this department is required to report to
application, you cannot apply such exemption to any period
the appropriate county auditor(s).
of time that is otherwise closed by operation of law (statute
of limitations).
9.c. Check the appropriate space to indicate if the costs for 9.a.
and 9.b. are actual or estimated.
17.
Provide the authorized signature of the person responsible
for filing this application. If not by an employee of the owner
10.a. Check the appropriate space to indicate whether the facility
of the facility, a TBOR-1 is required.
is completed, under construction or in the planning stage.
Note: If this facility is not completed, you must contact
18.
Print the name, title and phone number of the authorized
this department when the facility is completed because
person signing this application.
(absent special circumstances) the application will not
be forwarded to the Ohio EPA until the facility is
constructed and operational.
In order to expedite the processing of your application, please submit in triplicate the application and
all accompanying documentation (along with applicable fee) to: Office of Chief Counsel,
Tax Appeals Division, P.O. Box 530, Columbus, OH 43216-0530. Phone: (614) 466-6750.
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