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Financial Services
Sales Tax Division
215 North Mason Street, 2 ndFloor
P.O. Box 580
Fort Collins, CO 80522
970.221.6780
970.221.6782 - fax
fcgov.com/salestax
Manufacturing Equipment Use Tax Rebate Application
2022
Taxpayer (Company) Name Fort Collins License Number
Mailing Address Phone Number
Email Address
Contact Person
The following information is mandatory for the rebate process.
All financial information contained in this application will be confidential pursuant to City Code § 25-166 and applicable law.
Manufacturing Information:
Date manufacturing operations began in Fort Collins
What does your company manufacture?
Square footage of Fort Collins manufacturing facility
Square footage of entire Fort Collins facility
2021 real property tax valuation 2021 personal property tax valuation
2022 real property tax valuation 2022 personal property tax valuation
Who is your natural gas provider? Annual Gas Consumption
Rebate Information:
Purchase price of manufacturing equipment purchased in 2022
Amount of rebate requested:
Taxpayer authorizes the City to review and consider sales and use tax records, vendor records, contract and other information available regarding
Taxpayer’s eligibility for a rebate under this program.
I certify that Taxpayer is in compliance with all federal, state and local laws and regulations for the manufacturing facility located in Fort Collins. I also
certify that Taxpayer is current with all City of Fort Collins contractual, payment and sales and use tax obligations.
I declare under penalty of perjury that this claim (including any accompanying schedules and statements) has been examined by me and to the best of
my knowledge and belief is true and made in good faith for the stated purpose. Further, I represent and warrant that I have the necessary authority to
execute this application on behalf of Taxpayer, and to make the above certifications, authorizations, and declaration.
A claim by an agent must be accompanied by power of attorney.
Signature of Taxpayer Title Date
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