Rev. 05/15/11

.

STATE OF DELAWARE

HISTORIC PRESERVATION TAX CREDIT APPLICATION

REQUEST FOR CREDIT AWARD

OFFICE USE ONLY

Property Name / Project No.

Property Address

Instructions: This form is to be submitted with the Historic Preservation Tax Credit Application, Part 2 – Certification of Rehabilitation. Attach an estimate of the “qualified” expenditures associated with the project which has been prepared by or is certified by an accountant, a licensed architect, engineer, or contractor, or a certified construction cost estimator.

1. APPLICANT: Signature:

Organization (if applicable): Date:

Address: City: State: Zip:

Daytime Telephone Number: Email:

2. BASIS FOR COMPUTING CREDIT AWARD

Total “qualified” expenditures as documented in attached cost estimate:

Total estimate of costs of paving and landscaping:

Square footage of Certified Historic Property: Combined square footage of all additions:

Total “qualified” expenditures associated with construction of additions:

Square footage or percentage of building, if any, in owner-occupied residential use after rehabilitation:

Indicate under which category a Certification of Rehabilitation is being requested:

____ The Certified Historic Property is income-producing either for business or rental residential use.

(The Credit Award will be calculated at 20% of qualified costs; rehabilitation costs must equal or exceed adjusted basis.)

____ The Certified Historic Property is rental residential, and has received low income housing credits from the Delaware State Housing Authority.

(The Credit Award will be calculated at 30% of qualified costs.) [Note: documentation related to low income tax credits required.]

____ The Certified Historic Property is owned by a non-profit organization which will transfer the awarded tax credits.

(The Credit Award will be calculated at 30% of all qualified costs.)

____ The Certified Historic Property is solely an owner-occupied residence.

(The Credit Award will be calculated at 30% of qualified costs up to a maximum award of $20,000.)

____ The Certified Historic Property is an owner-occupied residence whose owner has an income level at or below 60% of the median gross

income for the County, adjusted by family size. [Note: additional documentation required.]

(The Credit Award will be calculated at 40% of qualified costs up to a maximum award of $20,000.)

____ The Certified Historic Property is occupied by a Resident Curator.

(The Credit Award will be calculated at 100% of the qualified costs up to a maximum award of $5,000.)

Required Attachment: _____ Estimate or final accounting of “qualified” expenditures

Optional Attachment: _____ Documentation related to low income criteria, if applicable

OFFICE USE ONLY:

____ The SHPO has issued a Certification of Rehabilitation, and has determined that the project is eligible for a Credit Award of $ .

____ The SHPO has determined that the project cannot be issued a Certification of Rehabilitation; therefore, no Credit Award can be assigned.

____ The SHPO has withdrawn the Credit Award for this project because the project was not “substantially commenced” within one year as required.

Date Delaware State Historic Preservation Officer Staff Reviewer/Telephone No.