Form Jobz1 - Jobz Certification - Certification Of Job Opportunity Building Zone (Jobz) Compliance With Business Subsidy Agreement (Bsa) Page 2
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1
2JOBZ Certification (JOBZ1) Instructions
Who must complete this form?
Eligibility requirements
Email address
If you are a qualified business participat-
As a qualified business, you are required to
If the department has questions regarding
ing in the Job Opportunity Building Zone
meet and maintain your eligibility require-
your Form JOBZ Certification form and you
(JOBZ) program, you must provide a fully
ments as determined by your business
want to receive correspondence electroni-
completed certification of eligibility each
subsidy agreement (BSA).
cally, be sure to provide your email address.
year with the Department of Revenue. This
Please note that:
Line 5
form is used to determine continued eligi-
Enter on line 5 the number of employees
bility to receive JOBZ benefits and must be
1.
Businesses that properly indicate “NO”
currently in the JOBZ zone. Do not use the
received no later than October 15.
on lines 1 or 3 are no longer eligible for
number of employees you had when you
JOBZ benefits, and are subject to the
Failure to submit the JOBZ Certification
entered the JOBZ program.
JOBZ repayment provisions of Min-
will result in removal from the JOBZ pro-
nesota Statute § 469.319.
gram. You will also be subject to repayment
Signature
of prior JOBZ tax benefits received.
Other businesses that properly indicate
An authorized representative of the quali-
2.
fied business must sign and date the form.
“YES” on line 1, but “NO” on line 7
This form is in addition to any other report-
may not be subject to repayment of
ing requirements with the Department of
When to file
JOBZ benefits, and under certain cir-
Revenue, the zone administrator, or the
By October 15, 2013, mail JOBZ Certifica-
cumstances may be eligible for limited
Department of Employment and Economic
tion form, to:
future JOBZ benefits.
Development (DEED).
Minnesota Revenue
In addition, businesses that have been
County and parcel ID number
Mail Station 9901
terminated from the JOBZ program but
Enter the county in which the qualified
St. Paul, MN 55146-9901
maintain a substantial level of the activities
business is located. Enter the main prop-
or fax to: 651-556-3102
described in the business subsidy agreement
erty’s parcel ID, or property ID, number
should continue to file this form for the
assigned to it by the county. You can find
Do not submit this form with your tax
duration of the zone term. Completing this
the parcel or property ID number on the
return.
form will assist the Department of Revenue
property tax statement.
in verifying the business’s continued opera-
Use of information
Minnesota business ID number
tions within the zone.
All information provided on JOBZ Certifi-
Enter the registered Minnesota business ID
cation form is public.
Qualified business
number. This is a seven digit number and is
The information will be used to administer
You are a qualified business if your place of
used to file your Minnesota tax filings.
the JOBZ program, and will be shared with
business is located within a JOBZ zone and
JOBZ ID number
the Department of Employment and Eco-
you have signed a Business Subsidy Agree-
Enter your Minnesota JOBZ ID Number
nomic Development to the extent necessary
ment with the zone administrator.
which can be located on your JOBZ M500
to administer the JOBZ laws.
A qualified business also includes an
form.
agricultural processing facility located in a
Questions or need forms?
designated agricultural processing facility
Business Subsidy Agreement
You can find forms and the most current
zone.
(BSA) date
information on our website at
In the area provided, enter the date the
qualified business’s Business Subsidy Agree-
If you have questions, call 651-556-6836
ment (BSA) was signed.
during business hours. TTY users, call
Minnesota Relay at 711.
We’ll provide information in other formats
upon request.
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