APPLICATION

ENTERPRISE ZONE INCENTIVES

Use For: (Check One

Sales Tax Refund on Purchases

Sales Tax Refund on Employment

Building Permit Fee Refunds

Date:

A. Business Name:

B. Business Address:

C. Owner's Name:

D. Contact Address:

E. Phone:

F. Fax #:

G. Start date in the Enterprise Zone:

H. Date of building permit granted by City of Lubbock:

I. Total number of employees:

J. Number of Employees who are Zone residents;

K. Please supply:

1. List of vendors and paid invoices for which local sales tax refunds are being claimed.

2. List of Zone-resident employees by zip code.

3. Copies of time sheets for refund on employment.

I affirm that the statements made in this application and supporting document are true and correct to the best of my knowledge.

Signature