EXHIBIT A
ILLINOIS AFFORDABLE HOUSING TAX CREDIT DONATION FORM
NFP SPONSOR NAME
PROJECT NAME
TOTAL DONATION AMOUNT
Is the donation proposed or actual?:
IAHTC REQUEST(50% of donation amount)
IDENTIFY POTENTIAL and ACTUAL DONOR(S)
Complete information below. Also provide back-up written documentationon commitment level of Donor and progress made in obtaining donations.
Donor InformationTypeEst. ValueMethod
Of Valuation
Donor:Cash
Address: Security
Real Property
Contact: PersonalProperty
Phone/Fax:
Donor InformationTypeEst. ValueMethod
Of Valuation
Donor:Cash
Address: Security
Real Property
Contact: PersonalProperty
Phone/Fax:
Donation TransactionNarrative:
Please provide 1-2 sentence summary of donation transaction. ( i.e. Donation source, Donation type, value of donation and how donation will be used in project. PLEASE explain how the NFP sponsor will transfer the donation into the ownership entity).
CertificateNarrative: Please provide the following information on where the certificate will be placed
Returned to Donor
Sold to Investor/Syndicator
Sold for : net cent raise.
Other:
Equity ProceedsNarrative:
If the certificate will be sold, please provide 1-2 sentence summary of how the equity will be transferred in the project. ( i.e. capital contribution from the NFP Sponsor, grant, loan, equity, etc.)
TECHNICAL ASSISTANCE AMOUNT * $
PURPOSE OF TECHNICAL ASSISTANCE
Complete if applicable. Technical Assistance is defined as any cost incurred by a Sponsor for:
- Planning for an Affordable Housing Project.
- Assistance with an Application.
- Counseling services for prospective purchasers
of a Single Family Residencewithin a Single Family
Project, except as provided in Section 355.408.
GENERAL OPERATING SUPPORT AMOUNT*
General Operating Support is defined as any cost incurred by a Sponsor in connection with an Affordable Housing Project that is a part of the Sponsor’s general operating cost. Operating costs are not limited to costs directly incurred in connection with the Affordable Housing Project, but may include general overhead expenses of the Sponsor.
PURPOSE OF GENERAL OPERATING SUPPORT
Provide a written narrative giving detailed itemization of general operating support to be utilized, and associated costs.
* No Affordable Housing Project, if approved, shall receive Affordable Housing Tax Credits for Technical Assistance and General Operating Support for the Sponsor of such Affordable Housing Project in an amount greater than 10% of the Allocation for such Affordable Housing Project.
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Donation Form 2008 expanded version.doc