OHIO HISTORIC PRESERVATION TAX CREDIT
PROJECT AMENDMENT INSTRUCTIONS AND FORM
FOR APPLICATION PERIOD: JULY 1, 2007 TO JUNE 30, 2008
Application Instructions
Read all Application Instructions carefully before completing the application and preparing the required attachments
Overview
After a project application has been submitted, any changes to the project application must be accomplished by written amendment and accepted by the Director of ODOD to be effective. Project amendments may include, but are not limited to, the following:
Major changes to the scope of work, such as adding or deleting work from the project. Increasing by more than 10% from the most recently supplied estimate, the dollar value of the estimated qualified rehabilitation expenditures. Changes to the rehabilitation beginning date. Changes in the ownership of the historic building. Changes in the anticipated end use(s) of the building.
If the application has not been approved by the Director of ODOD as of the date that the Project Amendment Form is received, the project amendment will be treated as a substitution for those parts of the original application affected by the amendment. If the application has been approved by the Director of ODOD, a project amendment will be treated as a request to approve the proposed amendment and for modification of the approved application. Amendments to approved applications will be communicated in writing to the applicant. Please send the completed project amendment form to: the Ohio Historic Preservation Office, 576 East Hudson Street, th Columbus, Ohio 43211, and to the Ohio Department of Development, Office of Tax Incentives, 77 S. High Street, 28 Floor, Columbus, Ohio 43216. NOTE: IF APPLICATION IS FOR A COMBINED STATE AND FEDERAL TAX CREDIT APPLICATION, SUBMIT SEPARATE AMENDMENT FORM(S) AS REQUIRED PER THE FEDERAL PROGRAM.
OHPTC Project Amendment Form AP7707t608 V1-0 D061407
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OHPTC CONTROL NO (ODOD / OHPO ONLY):
OHIO HISTORIC PRESERVATION TAX CREDIT
Application Amendment Form
FOR APPLICATION PERIOD: JULY 1, 2007 TO JUNE 30, 2008 All information submitted in connection with this application is considered public information and will be released in response to public record requests except to the extent such information is determined to be a “trade secret” as defined in Ohio Revised Code §1333.61(D). Any information considered by the applicant to be a “trade secret” must be clearly marked as such. Trade secrets may be marked by placing an asterisk before and after each line containing the trade secret information and underlining the trade secret information itself. 1) BUILDING LOCATION INFORMATION Name of Building: Address of Building: City: State: Ohio Zip Code:
2) PROJECT AMENDMENT INFORMATION This sheet amends: The Application Cover Form: Qualified Rehabilitation Expenditures Cost and Benefit Analysis Data Form Project Contact Owner The Application Form: Historic Building Designation Status Description of Physical Appearance Statement of Significance Photographs, Maps and Drawings Data on Building and Rehabilitation Project Detailed Description of Rehabilitation/Preservation Work 3) DESCRIPTION OF AMENDMENT Please provide narrative that describes the amendment. If necessary, attach additional documentation as needed in the Application Cover or Application Form for the item(s) amended:
OHPTC Project Amendment Form AP7707t608 V1-0 D061407
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OHPTC CONTROL NO (ODOD / OHPO ONLY):
4) PROJECT CONTACT Name (and Title): Street Address: Daytime Phone Number:
Organization: City / State / Zip code: Email:
I hereby attest that the information I have provided is, to the best of my knowledge, correct. I understand that falsification of representations in this application may subject the applicant to criminal sanctions, including fines and/or imprisonment pursuant to ORC 2921.77, and make the applicant ineligible for future state assistance pursuant to ORC 9.66. Owner or Authorized Representative’s Signature:
______________________________
Date: _______________________
Print Name of Owner or Authorized Representative: Street: Daytime Phone Number: City / State / Zip code: _______________________ Email: _ _______________________________
OHPO / ODOD ONLY
Ohio Historic Preservation Office The OHPO has reviewed this project amendment Comments / Notes: Yes No INITIALS (and Date) ____________
Ohio Department of Development The ODOD has reviewed this project amendment Comments / Notes: Yes No INITIALS (and Date) ____________
OHPTC Project Amendment Form AP7707t608 V1-0 D061407
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