Form It-Qbe - Qualified Business Expansion Application printable pdf download

Form It-Qbe - Qualified Business Expansion Application

IT-QBE

FOR DEPARTMENT USE ONLY

Project Number

GEORGIA DEPARTMENT OF REVENUE

1800 Century Center Blvd, Ste 15311

Date Received

Atlanta, Georgia 30345

Phone: (404) 417-2400 Fax: (404) 417-2438

Date Forwarded to Panel

Date Approved

QUALIFIED BUSINESS EXPANSION

APPLICATION

Date Denied

TO CLAIM THIS CREDIT YOU MUST HAVE BEEN OPERATING IN GEORGIA FOR FIVE YEARS AND MEET THE

REQUIREMENTS FOR AN EXISTING BUSINESS ENTERPRISE AS DEFINED BY O.C.G.A. 48-7-40.21. BY DEFINITION,

RETAIL BUSINESSES ARE EXCLUDED. (Applicable to all taxable years ending on or after January 1, 2001)

Tax Year End (year qualified business expansion occurred)

Name and address of Applicant/Taxpayer (Legal Name)

Nature of business:

Manufacturing

Processing

Telecommunications

Tourism

Warehousing & Distribution

Broadcasting

Research & Development

Telephone Number/E-mail Address of Contact Person

Date company began doing business in Georgia

_____________________________

Contact Person, Title

Taxable year in which 500 new full time jobs created

Indicate the address of the facility(s) where the 500 new jobs were created. (Attach a list if necessary.)

(REV 10/08)

Form It-Qbe - Qualified Business Expansion Application