Transfer Lihc Low-Income Housing Credit Statement - Massachusetts Department Of Revenue Forms - 2013

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2013
Transfer LIHC
Massachusetts
Low-Income Housing
Department of
Credit Statement
Revenue
For calendar year 2013 or taxable year beginning
and ending
Name of transferor
Social Security or Federal Identification number
Street address
City/Town
State
Zip
Name of transferee
Social Security or Federal Identification number
Street address
City/Town
State
Zip
Name of project
Building identification number
Street address
City/Town
State
Zip
Name of project owner
Federal Identification number
Street address
City/Town
State
Zip
Transfer Information
1 Total amount of credit being transferred . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Year(s) credit was earned by transferor
The undersigned is electing to make a transfer of the Massachusetts low-income housing credit and is notifying the Department of Revenue of this election
pursuant to 760 CMR 54.13(4). A copy of this statement should be attached to the transfer contract. A copy of this statement must also be submitted to the
Department of Revenue. Mail to: Massachusetts Department of Revenue, Audit Division, 200 Arlington Street, Room 4300, Chelsea, MA 02150,
Attn.: Low-Income Housing Unit.
Signature of transferor
Date
Name of contact person
Telephone number

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