Missouri Development Finance Board                                                                MISSOURI FORM 
               INFRASTRUCTURE DEVELOPMENT FUND TAX CREDIT 
               REQUEST FOR TRANSFER 
                                                                                                                          L 
 
The Missouri Form L must be used when transferring Infrastructure Development Fund Tax Credits.  A separate Form L must be 
submitted for each tax credit voucher being requested.  If more than one individual is listed as the Assignor/Assignee, the Social Security 
Number and signature of all individuals must be included. 

ASSIGNOR / Current Certificate Holder 
Date                            Name of Assignor(s) 
                                 
Federal ID No. (FEIN)                 Missouri Tax ID No.                        Social Security Number(s) 
                                                                                  
Contact Person                                                        Title 
                                                                       
Address                                                          City                                           State     ZIP Code 
                                                                                                                           
Telephone Number                               Fax Number                        E-mail 
                                                                                  
TRANSFER 
Amount of Approved Tax Credit              Approved Tax Credit Number                     Date of Contribution        Date of Transfer 
$                                                                                                                     
Per RSMo Section 100.286 (7), credits may be sold for no less than seventy-five percent (75%) of the par value of such credits or an 
amount not to exceed 100% of annual earned credits. 
           Amount of Tax Credits Sold                            Transfer Rate                            Sale Price 
$                                                                              %   $ 

Total Amount of Credit to be Transferred          $ 
CERTIFICATION 
  ·      I certify that I am an authorized representative of the Assignor and as such am authorized to make the statement of affirmation 
         contained herein. 
  ·      I certify under penalties of perjury, information contained in this document and attachments are complete, true, and correct to 
         the best of my knowledge and belief. 
Assignor Signature(s)                                                                               Title 
                                                                                                     
Print Name(s)                                                                                       Date 
                                                                                                     
NOTARY FOR ASSIGNOR 

Appeared before me this ____ day of ___________________, 20___, __________________________________________ to me 
personally known to be the person who executed the above certification, and acknowledged and states on his/her oath to me that he/she 
executed the same for the purpose therein stated. 
State of                                                                              County (or City of St. Louis) 
                                                                                       
Notary Public Printed Name                          My Commission Expires             Notary Public Seal/Stamp 
                                                     
Notary Public Signature 
 
RETURN                                          Mailing Address                           UPS or Fed-Ex Overnight Address 
COMPLETED                        Missouri Development Finance Board              Missouri Development Finance Board 
FORM TO:                         P.O. Box 567                                    200 Madison Street, Suite 1000 
                                 Jefferson City, Missouri  65102                 Jefferson City, Missouri  65101 

                                                             Form L Page 1 of 2                                           Rev. 3/09/2017 

               Missouri Development Finance Board                                                                MISSOURI FORM 
               INFRASTRUCTURE DEVELOPMENT FUND TAX CREDIT 
               REQUEST FOR TRANSFER 
                                                                                                                          L 

ASSIGNEE / New Certificate Holder 
Name of Assignee(s) 
 
Federal ID No. (FEIN)                 Missouri Tax ID No.                             Social Security Number(s) 
                                                                                       
Contact Person                                                        Title 
                                                                       
Address                                                          City                                           State     ZIP Code 
                                                                                                                           
Telephone Number                               Fax Number                             E-mail 
                                                                                       
ASSIGNEE/TAXPAYER TYPE (check one) 
 Corporation              Fiduciary            Individual Proprietorship         Partnership         S-Corporation        Individual 

Issued for Calendar Year                        or Tax Year Beginning                                  Ending    
If the taxpayer is a Fiduciary, Partnership, or S-Corporation, or other entity with a flow through tax treatment, identify the names, Social Security 
Numbers, and proportionate share of ownership of each beneficiary, partner, or shareholder.  The aggregate proportionate shares or percent of total 
ownership may not exceed 100%. Attach a separate sheet if necessary. 
                          Name(s)                                Social Security Numbers                  % Ownership Year End 
                                                                                                                                                      % 
                                                                                                                                                      % 
                                                                                                                                                      % 
                                                                                                                                                      % 
The taxpayer acquiring credits (assignee), may use the acquired credits to offset up to 100% of the tax liabilities otherwise imposed by RSMO Chapter 
143, excluding withholding tax imposed by Sections 143.191 to 143.261, RSMo Chapter 147, or RSMo Chapter 148. Per RSMo 100.286 (7), 
notwithstanding any other provision of law to the contrary, the amount received by the assignor of such credit shall be taxable as income of the 
assignor, and the excess of the par value of such credit above the price paid shall be taxable as income of the assignee. These credits cannot be used to 
amend a previously filed return by the original contributor or any subsequent assignee. An assignee may apply, claim and use the credit against taxes 
due in the immediately preceding tax year if the assignee’s return has not yet been filed AND the return is for a tax year beginning on or after the tax 
year of the contribution. Credits may be carried forward by the original Donor for up to five years after the year the contribution was made or may be 
transferred provided all credits shall be claimed and must be redeemed within ten years following the tax years in which the original contribution was 
made.   
CERTIFICATION 
 ·       I certify that I am an authorized representative of the Assignee and as such am authorized to make the statement of affirmation 
         contained herein. 
 ·       I certify under penalties of perjury, information contained in this document and attachments are complete, true, and correct to  
         the best of my knowledge and belief. 
Assignee Signature(s)                                                                               Title 
                                                                                                     
Print Name(s)                                                                                       Date 
                                                                                                     
NOTARY FOR ASSIGNEE 
Appeared before me this ____ day of ___________________, 20___, __________________________________________ to me 
personally known to be the person who executed the above certification, and acknowledged and states on his/her oath to me that he/she 
executed the same for the purpose therein stated. 
State of                                                                              County (or City of St. Louis) 
                                                                                       
Notary Public Printed Name                                My Commission Expires       Notary Public Seal/Stamp 
                                                           
Notary Public Signature 
                                                                           
                                                           Form L Page 2 of 2                                             Rev. 3/09/2017