Massachusetts Department of Revenue
                                         Transfer LIHC
                               Low-Income Housing Credit Statement                                                                                                                                                                         2020

For calendar year 2020 or taxable year beginning                                                                          and ending
Name of transferor                                                                                                                 Social Security or Federal Identification number

Street address                                                                                                                        City/Town                                                                      State              Zip

Name of transferee                                                                                                                 Social Security or Federal Identification number

Street address                                                                                                                        City/Town                                                                      State              Zip

Name of project                                                                                                                      Building identification number

Street address                                                                                                                        City/Town                                                                      State              Zip

Name of project owner                                                                                                           Federal Identification number

Street address                                                                                                                        City/Town                                                                      State              Zip

Transfer Information
1 Total amount of credit being transferred. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Year(s) credit was earned by transferor

The undersigned is electing to make a transfer of the Massachusetts low-income housing credit and is notifying the Department of Revenue of this election
pursuant to 760 CMR 54.13(4). A copy of this statement should be attached to the transfer contract. A copy of this statement must also be submitted to the
Department of Revenue. Mail to Massachusetts Department of Revenue, Audit Division, 200 Arlington Street, Room 4300, Chelsea, MA 02150, attn.
Low-Income Housing Unit.
Signature of transferor                                                                                                            Date

Name of contact person                                                                                                         Telephone number