Utah Governor’s Office of Economic Development

Application Process

• Meet with GOED incentives team to complete and submit application by July 1, 2011; contact Zachary Derr at (801) 538-8746 or zderr@utah.gov to arrange meeting
• Incentives applications will be considered by the GOED Board’s Incentives Committee during July after which a preliminary decision is recommended to the full GOED Board
• The GOED Board will make a final decision on the incentives application by August 1, 2011
• GOED sends a Commitment Letter to the company detailing the incentives offer and performance milestones
• The company countersigns and returns the Commitment Letter to GOED
• Company enters into an agreement with GOED for tax credits
• GOED issues a tax certificate to the company on an annual basis after required documentation is approved by the office

State of Utah Life Science Incentive Application*
Non-refundable Tax Credit for Investment in Certain Life Science Establishments
Please respond to each point in a separate document using the same numbering system to correspond with your information.

1. Company Information
· Company Name, Mailing and Street Address
· Point of Contact for this Application, Telephone, Email Address and Fax number
· PR/Company Communications Contact, Telephone, Email Address and Fax number
· Federal tax ID number
· Utah State Tax Commission sales tax, corporate tax and payroll withholding tax account numbers
· Business Entity Type Claimed on Tax Return

2. Company Overview
· Briefly describe the history of the company, its products, services, and markets. Outline management strengths and experience

3. Investment Information
· Through purchase agreement, operating agreements or other means please document your planned overall investment and percentage ownership of a qualifying Utah Small Business
·  If the project involves the physical expansion of the business, provide a letter of support for project from local municipality or explanation as to why this cannot be obtained.  To find contact information for your local economic development professional please visit the following website: http://www.edcutah.org/documents/EDDirectory_010411.pdf or call Sherri Martell at (801) 328-8839 or email at smartell@edcutah.org
· Applications will be prioritized and awarded based on recommendations by an independent review committee and approval by the Governor’s Office of Economic Development (GOED) Board of Directors

4. Complete Forms
· Submit a signed document directing and authorizing the Utah State Tax Commission to disclose to GOED your tax returns and other confidential information that would otherwise be subject to confidentiality under UCA 59-1-403
· To have specific information about your company be kept confidential, please submit a GRAMA FORM, otherwise all information will become public if the application is approved by the GOED Board

5. Submit
Submit ELECTRONIC copies of all application material to Zachary Derr at zderr@utah.gov

* Additional information may be requiested during the application process.

Downloads

• Request for Protected Records Status
• Authorization to disclose records