HomeMy WebLinkAboutTIF Tax Exemption ApplicationCity of Iowa City Application
TIF Tax Rebate or Tax Abatement\Exemption
Business Requesting Financial Assistance:
Business Name: ___________________________________________________________
Name of Authorized Person to Obligate the Business: _____________________________
Business Address: __________________________________________________________
Business Contact Person: ________________________ Title: _______________________
Telephone: _____________________________ Fax: _____________________________
E - m a i l A d d r e s s : _ _ _ _ _
Business Federal ID#: ______________________________________________________
Date of Application Submi t t a l : _ _ _ _ _
Release of Information and Certification
NOTE: Please read carefully before signing
I hereby give permission to the City of Iowa City (the City) to research the company's history,
make credit checks, contact the company's financial institution, and perform other related
activities necessary for reasonable evaluation of this proposal. I understand that all information
submitted to the City relating to this application is subject to the Open Records Law (1994 Iowa
Code, Chapter 22) and that confidentiality may not be guaranteed. I hereby certify that all repre-
sentations; warranties or statements made or furnished to the City in connection with this
application are true and correct in all material respects. I understand that it is a criminal violation
under Iowa law to engage in deception and knowingly make, or cause to be made, directly or
indirectly, a false statement in writing for the purpose of procuring economic development
assistance from a state agency or political subdivision.
SIGNATURE OF COMPANY OFFICER AUTHORIZED TO OBLIGATE BUSINESS:
_________________________________________________________________________
NOTE: The City will not provide assistance in situations where it is determined that any repre-
sentation, warranty or statement made in connection with this application is incorrect, false,
misleading or erroneous in any material respect. If assistance has already been provided by the
city prior to discovery of the incorrect, false or misleading representation, the city may initiate
legal action to recover city funds.
1. What is the location of the proposed project?
2. Please provide a brief timeline for the proposed project.
3. Describe in detail the proposed "project" (e.g., company relocation, plant expansion, remodel-
ing, new product line and/or new facility).
4. Specifically, what type of capital improvements will be completed? (e.g. new building,
remodeling, façade improvement, accessibility)
5. Will the project increase the value of the property by at least 15%? Please include the amount
of the proposed investment.
6. Type of assistance requested: (check one)
Tax Increment Financing _______
Tax Exemption _______
Tax Abatement _______
7. If an existing Iowa City business, how many total individuals have been employed by the
company at the Iowa City facility during the past year?
8. What is the number of jobs within the existing or proposed Iowa City facility and what is the
starting average hourly wage rate (not including fringe benefits):
For the new employees? ____________________________________________________
For existing employees? ____________________________________________________
For existing and new employees? _____________________________________________
9. Does the business provide standard medical and dental insurance for full-time employees? If
so, what percentage of the standard medical and dental insurance package expense does the
company provide?
10. Beyond the present project, what future growth potential is there for the Iowa City operation?
11. Please describe the energy and resource efficiency programs, waste reduction, waste
exchange, and/or recycling programs at your Iowa City operation.
12. Do you use recycled materials in the production of any products or through the provision of
any services at your facility? If so, please describe.
13. Has the business been cited or convicted for violations of any federal or state laws or
regulations within the last five years (including environmental regulations, Occupational Safety
And Health laws, Fair Labor Standards, the National Labor Relations Act, the Americans With
Disabilities Act)? If yes, please explain the circumstances of the violation(s).