"Job Creation/ One Maryland Tax Credit Employment Affidavit" - Maryland

Job Creation/ One Maryland Tax Credit Employment Affidavit is a legal document that was released by the Maryland Department of Commerce - a government authority operating within Maryland.

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Download "Job Creation/ One Maryland Tax Credit Employment Affidavit" - Maryland

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Job Creation/ One Maryland Tax Credit Employment
Affidavit
Applicants for the Job Creation and/ or One Maryland Tax Credit are required to complete and
sign this affidavit.
Indicate below the number of full-time employees for each item requested. Begin with the intent
date and work backward two years. This affidavit will be used to determine the base
employment. The employment numbers for prior years will be averaged. The higher of the
average number or the employment at the time of intent will result in the base employment.
Business Name:
______________________________________________________
Business
(Street Address)
Facility
Address:
(City)
(State)
( Zip)
Facility
State-wide
Full-time
Annual Payroll
Full-time
Annual Payroll
Employees
($000s)
Employees
($000s)
Intent Date
One Year Prior to
Intent Date
Two Years Prior To
Intent Date
I solemnly affirm under the penalties of perjury and upon personal knowledge that the contents
of the foregoing paper are true.
___________________________
______________________
Name (Print)
Title
___________________________
______________________
Name (Signature)
Date
Job Creation/ One Maryland Tax Credit Employment
Affidavit
Applicants for the Job Creation and/ or One Maryland Tax Credit are required to complete and
sign this affidavit.
Indicate below the number of full-time employees for each item requested. Begin with the intent
date and work backward two years. This affidavit will be used to determine the base
employment. The employment numbers for prior years will be averaged. The higher of the
average number or the employment at the time of intent will result in the base employment.
Business Name:
______________________________________________________
Business
(Street Address)
Facility
Address:
(City)
(State)
( Zip)
Facility
State-wide
Full-time
Annual Payroll
Full-time
Annual Payroll
Employees
($000s)
Employees
($000s)
Intent Date
One Year Prior to
Intent Date
Two Years Prior To
Intent Date
I solemnly affirm under the penalties of perjury and upon personal knowledge that the contents
of the foregoing paper are true.
___________________________
______________________
Name (Print)
Title
___________________________
______________________
Name (Signature)
Date