Form 402ap 9901 - Application For New Business Facility Tax Credits

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STATE OF DELAWARE
Department of Finance
APPLICATION FOR NEW BUSINESS FACILITY
Division of Revenue
TAX CREDITS
Reset
820 N. French Street
P.O. Box 8911
Print Form
Wilmington Delaware 19899-8911
FORM 402AP 9901
THIS APPLICATION MUST BE COMPLETED AND FILED WITH THE DIVISION OF REVENUE PRIOR TO CLAIMING ANY
CORPORATE INCOME TAX CREDITS OR REDUCTIONS IN LICENSE TAXES PURSUANT TO CHAPTER 20, TITLE 30, DELAWARE CODE.
PART A -- NAME AND ADDRESS
1.
Federal Employer Identification Number
1 ---
2. Name of Taxpayer
3. Address
4. Location of qualifying business facility (if different from above).
5. Contact Person
Telephone Number
(
)
PART B -- BUSINESS ACTIVITIES
Check the appropriate qualifying activity(s)
Wholesaling
Aviation Maintenance & Repair Services
Management & Support Services for Activities listed
Computer Software Sales (Wholesale Only)
Combination of Activities listed
Consumer Credit Reporting/Collection Services
Occupational Licenses -- Targeted Areas Only
Data Processing or Data Preparation
Retailing -- Targeted Areas Only
Engineering
Other
________________ --
Brownfield Areas Only
Manufacturing
Other
________________ -- Green Industries Only
Scientific, Agricultural or Industrial Research
Telecommunications
Check the appropriate type of facility
New facility
Expansion with new employees
Replacement facility
Expansion without new employees
Located on a Brownfield (Verification required from DNREC)
PART C -- QUALIFYING FACILITY INFORMATION
1. Enter the date the facility was placed in service.
2. Enter the value (at original cost if owned by the taxpayer, or eight times the annual rent paid less any amounts received as subrentals if leased) of
the real and tangible personal property, except inventory or property held for sale to customers, which constitutes the new business facility or
which is used by the taxpayer in the operation of the business facility. Include in this investment amount all costs expended by the taxpayer for
environmental investigation and remediation if such facility is located on a brownfield.
$
3. If the qualifying facility is leased, provide the name, address and federal employer identification number of the lessor.
F.E.I.N
4. Enter the number of new business facility employees employed by the taxpayer on a regular and full-time basis in the operation of the new,
replaced or expanded facility.
5. If the qualifying facility has been acquired from another, provide the name, address and federal employer identification number of the previous
owner.
F.E.I.N
6. Is the taxpayer or firm related to the individual or firm listed above? [ ] YES
[ ] NO
If yes, please describe the relationship.
Signature
Date

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