Form 5502tr-9811 - Application For Reduction Of Public Utilities Tax - 2013
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1
22013
STATE OF DELAWARE
Department of Finance
APPLICATION FOR REDUCTION
Division of Revenue
OF PUBLIC UTILITIES TAX
820 N. French Street
P.O. Box 2340
FORM 5502TR-9811
Wilmington, Delaware 19899-2340
THIS APPLICATION APPLIES TO MANUFACTURERS, FOOD PROCESSORS AND AGRI-BUSINESS PROCESSORS.
IT MUST BE COMPLETED AND FILED WITH THE DELAWARE DIVISION OF REVENUE TO QUALIFY FOR THE 2% REDUCTION
IN THE ELECTRICITY AND GAS COMMODITIES TAX (IMPOSED BY CHAPTER 55, TITLE 30 OF THE DELAWARE CODE).
1.
Enter Federal Employer Identification Number
OR
Social Security Number
1 -
2 -
2.
Name
3.
Address
4.
Location of Facility (if different from above)
5.
Division of Revenue Business License Number
6. Check One or More:
[ ] Manufacturer
[ ] Agri-business
[ ] Food Processor
[ ] Chicken Hatching
7.
Utility Name/Utility Account Number(s)
A SEPARA
TE APPLICATION FORM MUST BE COMPLETED FOR EACH DELAWARE BUSINESS FACILITY
8.
Enter the number of employees located at this facility who are engaged
exclusively in the management or administrative support of or employed
exclusively in manufacturing, food or agri-business processing or the
hatching of chickens in conjunction with operating a food or agri-business
processing business within Delaware.
9.
Enter the number of employees located at this facility who perform
services related to or in support of any business activity conducted
outside Delaware.
10.
Enter the total number of employees at this facility. Add Lines 8 and 9.
11.
Divide Line 8 by Line 10 and enter the percentage here.
For the facility to qualify for the Public Utility Tax Reduction, Line 11 must be greater than 70%.
Signature
Telephone Number
Date
I declare under penalties as provided by law that the information on this application is true, correct and complete.
FOR DIVISION OF REVENUE USE
APPROVED [ ]
DISAPPROVED [ ]
Signature
Title
Date
*DF40613019999*
(Revised 01/28/13)
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