Project Application For Eligibility For Sales Tax Exemption
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1Project #
PROJECT APPLICATION FOR ELIGIBILITY FOR SALES TAX EXEMPTION
DECATUR/MACON COUNTY ENTERPRISE ZONE (Jan. 1, 2016)
Name of Business(Project)
___________________________________________________
Project Street Address:
___________________________________________________
City/State/Zip:
___________________________________________________
Owner's Name:
___________________________________________________
Owner's Address:
___________________________________________________
Project Representative:
___________________________________________________
Project Description ( i.e. rehab, new construction, expansion, new location etc.)____________________
____________________________________________________________________________________
Total Project Cost $
= Land $_________
+ Building $_________
+
M&E $________
+ Other $_
______
Current Employment
_________
Jobs Created _______
__
Job Retained ________ __
NAICS Code:
______________________
Property ID Number
______________________
FEIN (Federal Employer Identification Number) ______________________
Please attach building permit; a separate Contractor Application form (Addendum A)for each
contractor purchasing materials for the project with the construction materials list-i.e.
hvac,electrical, site work, concrete, building materials, etc. and projected costs for each.
A ½% Administration Fee based on documented cost of attached construction materials lists is
assessed.
_____________________________
___________________________
______________
Signature - Project Representative
Title-Project Representative
Telephone
CERTIFICATION OF ELIGIBILITY
This is to certify that the project named above is located within the DECATUR MACON COUNTY
ENTERPRISE ZONE and is eligible for the State of Illinois and Local Sales Tax Exemption on building
materials associated with rehabilitation, renovation, and/or new construction for this project. Once the
rehabilitation, renovation, and/or new construction is complete and all building materials required for this
project have been acquired, the owner, general contractor and/or sub-contractors are no longer eligible
for exemption for this project. Any new project on the same site/premises will require a separate
certification by the Illinois Department of Revenue. Please retain a copy of this application for your
records.
____________________________________
________________________
Ryan McCrady, Zone Administrator
Submission Date
Decatur Enterprise Zone
% EDC of Decatur and Macon County
101 South Main – Suite 101
T) 217.422.9520
Decatur, Illinois 62523
F) 217.422.9307
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