<p> FAIRMONT CITY/CASEYVILLE/BROOKLYN ENTERPRISE ZONE APPLICATION INSTRUCTIONS </p><p>PLEASE READ CAREFULLY BOTH THE ENTERPRISE ZONE APPLICATION FORM AND SALES TAX CERTIFICATE</p><p>THE APPLICANT FORM MUST BE COMPLETED BY APPLICANT AND POTENTIAL CONTRACTOR, THEN CERTIFIED BY THE ENTERPRISE ZONE ADMNISTRATOR BEFORE YOU ARE ELIGIBLE FOR INCENTIVES </p><p>Information and items needed to complete applications </p><p>1. Approved building permit 2. Project address 3. Contractors names and address 4. Number of full and part time employees 5. Estimated Starting date and completion date (The starting date must not be sooner than approval date of application) 6. Project cost (include all cost and capital equipment) 7. Federal employers ID # 8. Illinois Unemployment Insurance number (A new company can notify us of these new numbers when received) 9. Copy of deed and correct parcel number</p><p>*Reporting Instructions Applicants are also now required to file reports with the Illinois Department of revenue upon receiving Enterprise Zone incentives. You are highly recommended to visit this website for Frequently Asked Questions regarding the program. http://www.revenue.state.il.us/Businesses/Incentives/</p><p>If you have any questions in completing these application forms, contact: </p><p>Scott Penny, Zone Administrator C/O Fairmont City Village Hall 2601 N.41st. Street Fairmont City, IL 62201 Office: 618-274=4504 Fax: 618-274-4010 e-mail:[email protected]</p><p>A certificate fee is now in effect. The fee is .005 of the building materials cost in item 3.</p><p>Make checks payable to Fairmont City, Caseyville, and Brooklyn E Zone, send forms and checks to Zone Administrator, 2601 N. 41st. Street, Fairmont City, IL 62201 FAIRMONT CITY/CASEYVILLE/BROOKLYN ENTERPRISE ZONE PROJECT INFORMATION</p><p>Name of Business applying for Enterprise Zone designation: </p><p>______</p><p>E-Zone project address: ______</p><p>Owner or Contact Person: ______</p><p>Address: ______</p><p>Phone: ______</p><p>Email address: ______Fax Number: ______</p><p>Tax Bill Mailing Address: ______</p><p>Business owner (if different than Contact) Name of Individual or Company: ______</p><p>Address: ______Phone: ______</p><p>Type of Business: ______Commercial ______Industrial </p><p>Product(s) or Service: ______</p><p>Permanent (full-time) employees: ______Temporary (full-time) employees: ______</p><p>Estimated Date of Project Start: ______Completion: ______</p><p>Estimated Cost of Project: (Amounts for 1 and/or 2 must coincide with building permit.) (Abatement of sales tax exemption will not be given over amounts declared.) </p><p>1) Remodeling $______2) New Construction Cost $______3) Building Materials Cost $______4) Capital Equipment $______5) Site (purchase and preparation) $______</p><p>JOBS: Number of full-time Equivalent Jobs- (Total hours worked by fill-time and part-time employees divided by 40.)</p><p>Retained due to project: ______Created within one year due to project: ______Description of project: ______</p><p>Federal Employer Identification Number: ______</p><p>IL Unemployment Insurance Number: ______</p><p>NAICS Code Number: ______</p><p>Does this project involve a move from another location: ______</p><p>If yes, indicate city and state of previous location: ______</p><p>______Signature of Project Representative Title Date </p><p>NOTE: A COPY OF THE APPROVED BUILDING PERMIT, PARCEL NUMBER OR COPY OF DEED MUST BE SUBMITTED BEFORE PROJECT WILL BR APPROVED. ************************************************************* (To be filled in by Enterprise Zone Administrator.)</p><p>Township: ______Tax Code: ______</p><p>Building Permit # ______</p><p>Grantor: ______</p><p>Number: ______</p><p>Date: ______</p><p>(Dollar Amount of Building Materials from #3 on front):______</p><p>X .005 = ______Enterprise Zone </p><p>Project is Accepted ______Rejected______Place E-Zone Approval Stamp Below Comments: </p><p>Signature of Enterprise Zone Administrator</p><p>______</p>