13501350 STATE OF SOUTH CAROLINA PT-443 DEPARTMENT OF REVENUE Rev. (9/29/06) PT-443 FEE IN LIEU OF PROPERTY TAX (Rev. 3/12/08) 7071 INITIAL REPORT FORM 7071 INITIAL REPORT (to be filed within 30 days of execution of a fee agreement or an inducement agreement) 1. Legal Name of Investor 1) (Include information about 2) each party investing in the 3) Fee, if more than one investor, and how they qualify under the fee statutes.) 2. Federal Employer ID 1) 2) 3) 3. Business Sole Proprietor Partnership LLC Corporation - State of incorporation:__________ (Check all that apply if more than one investor and supply an explanation.) 4. Principal Business Mailing Street/POB Address City, State, 9 Digit Zip Code 5. Physical Location of Project Street Address: City/State/Zip 6. County or Counties 7. Minimum Investment agreed upon 8. Is the project in a Yes No If yes, please identify: (See SC Code § 4-1-170) multicounty park? 9. Contact Person for Investor(s) 10. Telephone Voice: ( ) Fax: ( ) 11. Taxpayer's Legal Counsel Telephone: ( ) for FILOT Fax: ( ) 12. Nature of Business SIC Code: 13. Accounting Closing Date Used for Income Tax Purposes 14. Type of Operation Manufacturer (include product manufactured) Research & Development Office Facility Distribution Facility Corporate Headquarters Other (describe): 15. Date of Fee Agreement (Simplified Fee) or Date of Inducement Agreement (Big or Little Fee): 16. Type of Fee §4-12-30 ("Little Fee") §4-29-67("Big Fee") Chapter 44, Title 12 ("Simplified Fee") Check if applicable: Super/enhanced fee $1 million+fee 17. Property to be Included Land Buildings Building Additions Personal Property Under the Fee: ( If available, attach survey of real property covered by the Fee) 18. Initial Negotiated Fixed Variable Agreement page, para. §: Assessment Ratio 19. If variable, state the different rates and the years for which they are applicable. 70711015 |
20. Initial Negotiated Millage Fixed Variable Agreement page, para. §: Rate 21. Explanation, if necessary 22. Calendar Year of Anticipated Initial Investments Agreement page, para. §: 23. Length of Fee Agreement page, para. § (Number of Years) 24. Payment Structure Regular Payments Equal Payments 5 Year Millage Adjustment Agreement page, para. §: Other (explain): 25. Discount Rate Used for net present _______ % Not Applicable Agreement page, para. §: value purposes 26. Does Agreement Allow For Disposal of Property? Replacement of Property? Agreement page, para. § Yes No Yes No 27. Min. No. of Jobs Required Not Applicable Agreement page, para. § (if applicable) 28. Any additional information, allowances, or restrictions of which one must be aware to calculate or verify the fee under this agreement: Agreement page, para. §: Agreement page, para. §: Agreement page, para. §: I declare that this return, to the best of my knowledge and belief, is true, correct, and complete. Prepared by (please print): Title: Signature: Date: Telephone #: E-mail Address: Attachments: Fully executed fee agreement or inducement agreement Survey of real property under the fee (if available) Inducement Resolution or other project identification. Millage rate agreement (if applicable) Any other attachments needed to respond to the questions. The investor will need to file a supplemental form (form to be determined by the Department of Revenue) at the time that the investor executes the lease agreement and/or places the property in service in this State. 70712013 |