NewPA.com Single Application Municipal Statistics Investment Tracker Help
 

Required fields are marked with a

Please let us know whether you have previously submitted KOZ application, or this is the first time:

1. Is this application for benefits for a (check all that apply):

Failure to check all that apply will limit your benefits.

2. Business/Resident/Property Owner
3. KOZ Property Address
4. Municipality Information    
5. Property Tax Information

Add 1st Parcel ID:
Add

(Click here)

Note: "LOT" is not a Parcel ID#.

6. Date Information (mm/dd/yyyy)

7. Entity Type

Indicate how your entity type reports to the Internal Revenue Service.

If LLC selected, is the LLC a
(mandatory if Business selected) :

NAICS Code NAICS Code: Find Code
8. Special Apportionment
9. Job Creation and Investment

This section must be completed. If not applicable, enter zero.

Previous Year ():

10. Tax ID Numbers

MUST be provided for applications from a business entity.

 

11. Social Security Numbers

Please enter SS# (if you are property owner, resident, or a sole proprietor):

12. Shareholder/Partner/Member Information

Provide the information requested in the boxes below for the following entities: all share holders, partners, members, etc, of an S Corp, Partnership, LLC and all persons or business that will receive pass through income from the business. (If you need additional space PLEASE attach a Microsoft Excel spreadsheet)

  Name SSN/EIN Phone Ownership % Street Address City State ZIP  
1    
2      
3      
4      
5      

13. Mailing Address

Where correspondence concerning all KOZ issues should be mailed

Please note that any non-compliant tax issue can only be communicated with the contact listed. It is the responsibility of the contact listed to forward the information to the appropriate tax contact if the contact provided is different.

14. Contact Information
15. Please enter name of person completing application