Commercial And Industrial/manufacturing Expansion Programs - Application And Instructions - New York City Department Of Finance Page 9

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NEW YORK CITY DEPARTMENT OF FINANCE
CRP/CEP EXEMPTIONS UNIT
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PROOF OF EMPLOYMENT
TM
Department of Finance
Mail to: NYC Department of Finance, CRP/CEP Exemptions Unit, 59 Maiden Lane, 22nd Floor, New York, NY 10038
APPLICANT INFORMATION
1. Application
Number:_____________________________________
2. Borough:________ Block: ________ Lot: _________
.
3. Tenant’s
4. Tenant’s
Name: ______________________________________
Telephone Number: ___________________________
5. Property
6. Floor/Room
7. Zip
Address: _____________________________________
Number: ______________
Code: _____________
NUMBER AND STREET
8. Lease
9. Rent
Commencement Date: ________/________/________
Commencement Date: ________/________/________
EMPLOYEE INFORMATION
1. List the number of persons employed or who will be employed in the
eligible premises indicated above, as of sixty days after rent commencement: ____________________
2. List the number of persons in question #1 who are residents of New York City: ____________________
NOTE: THE ANSWER TO QUESTION #2 IS NOT A DETERMINANT OF ELIGIBILITY FOR THIS PROGRAM
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CERTIFICATION/AFFIDAVIT
STATE OF NEW YORK
SS
COUNTY OF________________
______________________________________, being duly sworn, says that under penalty of perjury, the he/she is the applicant or
the____________________________________, an officer of the applicant, that the information contained on this document, includ-
ing any attachments to this document, are true to his or her knowledge.
Subscribed and sworn to before me this _______ day
_________________________________
of_____________________________ 20__________
SIGNATURE OF APPLICANT OR OFFICER
( )
q
q
TENANT
OWNER
___________________________________________
:
NOTARY PUBLIC
STAMP OR SEAL
Visit Finance at nyc.gov/finance
PRO-9702 05.02.2014

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