Form 3694 - Request For Certificate Of Completion For Brownfield Redevelopment Credit Project Form Page 4

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3694, Page 4
PART 4 GENERAL INFORMATION
21. Provide a description of the completed project.
22. Describe any changes made to the project since the Brownfield Redevelopment Credit Project Preapproval
Application was submitted. If form 3825 Request to Amend SBT Brownfield Redevelopment Credit Project
Preapproval Application was filed and approved, attach a copy.
23. Are the types and number of permanent and temporary jobs created as a result of the project different than what
was reported on the Preapproval Application?
No
If Yes, please describe the types and number of
Yes
jobs actually created and explain why they are different than originally reported.
24. Did the project involve a move from another location in this state as a result of the eligible investment?
Yes
No
If Yes, enter the address of the property from which you moved or are moving. Is there a new owner or occupant of
that property?
Yes
No
If Yes, please identify. If No, explain whether you will have any clean-up
responsibility for the former location and why the former location will not become blighted or functionally obsolete.
25. Was investment on the eligible property started before the date of the Preapproval Letter?
Yes
No
If Yes, attach a detailed list of investments made before that date.
26. Attach a copy of the Preapproval Letter that was issued for this project.
27. Attach a copy of the certificate of occupancy showing that the property has passed all inspections (if applicable).
28. Attach a detailed accounting of the cost of the project, including a financial statement for the project.
Continued on Page 5.

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