Enterprise Zone project application

Project information
Name of project(Required)
Project address(Required)
Street Address Address Line 2 City State ZIP Code
Project Contact Person(Required)
First Last
Phone(Required)
Email(Required)
Business legal name(Required)
Address (if different from above)
Street Address Address Line 2 City State ZIP Code
Business FEIN number(Required)
Illinois unemployment insurance number
Description of project(Required)
Estimated project start date(Required)
MM slash DD slash YYYY
Estimated project end date(Required)
MM slash DD slash YYYY
Estimated project numbers
Building material cost(Required)
Labor cost(Required)
Current number of full-time equivalent employees(Required)
Jobs retained due to project
Jobs created within one year due to project
Total full-time equivalent employees at project completion(Required)
Consent(Required)
As the owner or authorized agent for the owner, I hereby certify that the information provided in this application for Enterprise Zone benefits for the property shown is accurate. I acknowledge that I will be required to report closing cost and jobs created numbers to Sasha Althoff, Enterprise Zone Administrator, at project completion and all Enterprise Zone Benefits (property tax exemption, sales tax exemption, ect.) to the Illinois Department of Revenue by May 31st of the following year by visiting http://www.revenue.state.il.us/business/incentives/. I understand that failure to report and report accurately can result in losing the ability to participate in the Enterprise Zone program in the future.

By typing your name below and clicking on “I Agree” below, you acknowledge and agree to the following:
• I have read, understood, and agree to the terms and conditions of the Effingham Enterprise Zone program.
• I agree that my electronic signature is the equivalent of a manual signature and that the City of Effingham, Illinois, may rely on it as such in connection with any and all agreements that I may enter into with the City of Effingham, Illinois, and any documents I electronically sign for the City of Effingham, Illinois;
• I acknowledge and agree that it is my obligation to immediately advise the City of Effingham, Illinois of any change in my electronic address (i.e. email address);
• I acknowledge and agree that it is my obligation to immediately advise the City of Effingham, Illinois, in the event I withdraw my consent to use electronic means for the application and/or account;
• I acknowledge and agree to the terms and conditions contained within the Online Application E-Signature and Electronic Disclosure Agreement
• I acknowledge and agree that the various security and verification procedures adopted by the City of Effingham, Illinois, in connection with the Enterprise Zone Project Application, as well as any other documents that I will affix my electronic signature constitute reasonable and secure security procedures and that all signatures are attributable to the person whose name is typed below;
• I acknowledge and agree that the individual completing this Enterprise Zone Project Application is the individual who will be in charge of the project. By typing your name below, you understand that you are electronically signing this document and are agreeing to all of the policies, terms, and conditions set forth above. You further understand that the City of Effingham, Illinois, will rely upon your electronic signature to the same extent as if you had signed this document in ink. If you do not understand or accept or agree to the policies, terms, and conditions set forth above, then Do Not click on the “I Agree” button and exit this site.

I agree to the terms and conditions.
Electronic signature (your name)(Required)
First Last
Today's date(Required)
Month
Day
Year
CAPTCHA
Name
First Last
Date
MM slash DD slash YYYY
Number
Enterprise Zone Application Fee
At the time of application, an Enterprise Zone application fee is required. The fee is calculated as 0.5% of the cost of building materials. The Enterprise Zone Administrator will review the application, determine the fee amount, and send an invoice via email. Payment must be received before any Building Materials Exemption Certificates will be issued.
- I understand

Enterprise Zone project application

Project information

Estimated project numbers