CITY OF LAWRENCE
APPLICATION FOR PROPERTY TAX ABATEMENT
AND/OR INDUSTRIAL REVENUE BONDS
(REVISED 12/2005)
Open the Microsoft Word Document
I. General Information
Date of Request:___________________
Name of Applicant Firm:________________________________________________
Local Address:_________________________________________________________
Telephone Number:_____________ Fax Number:______________
Email Address:___________________________
Headquarters Address:__________________________________________
Telephone Number:_________________Fax Number:______________
Email Address:______________________________
Names and Titles of local principal officers and corporate directors of the applicant:
Name:_____________________ Title:_______________________
Name:_____________________ Title:_______________________
Name:_____________________ Title:_______________________
Name:_____________________ Title:_______________________
Names and addresses of all persons or firms that will be listed as owner(s) of the property to be abated:
Name:____________________________________ Address:___________________________________
Name:____________________________________ Address:___________________________________
Name:____________________________________ Address:___________________________________
Name:____________________________________ Address:___________________________________
Provide a brief history of your company, including types of products and services provided.
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Describe in general terms the legal structure of your business. More specifically, indicate how your business is organized (i.e., corporation, partnership, etc.), state of domicile, ownership, subsidiaries or affiliates and any other information necessary to understand how you are legally organized.
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Enclose copies of the company's audited and interim financial statements for the past three years. Financial statements reviewed or compiled by an independent auditor may be submitted if there are no audited financial statements.
Enclose copies of the company's federal income tax returns for the past three years.
Attach to this application the names, locations and contacts of other governments from which you have received or applied for tax abatements and/or industrial revenue bonds if applicable
____ Check here if NOT applicable.
II. Nature of the Improvements
Location of Improvements: _________________________________________________________
Land to be purchased: _________________________________________________________
- Sq. feet or acres:_____________
- Value:______________
New Construction or modification:_____________________________
- Sq. feet or acres:_____________
- Cost: $____________________________
Identify Construction or modification:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
New Machinery and Equipment (include approximate purchase dates and estimated useful life).
Description:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Cost: ___________________________
Is the proposed project the result of relocation from another state or county, an expansion, new company, or replacement of your existing facility? ________
Please state the reason for the establishment of the new facility or the expansion or replacement of the existing facility.
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Will the improvements be financed with Industrial Revenue Bonds? If so, what is the amount of the proposed issue and will it be non-taxable?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
What is the approximate starting and completion dates for the project? The completion date is defined as the date you will be ready to utilize the new or expanded facility and/or equipment.
Start Date: _____________________ Completion Date: _____________________
III. Proposed Use and Economic Benefit
What type of new or expanded business activity is proposed by the applicant?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
List the new products or services to be rendered. (Include details of the nature and scope of the operation of the business.)
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
What percentage of the facility will be occupied by the applicant? _________________________
Does your product pose or create an environmental hazard when it is produced, destroyed, or discarded?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Please list all new employees and proposed wages, excluding fringe benefits, by the job titles included in the Annual Wage Survey prepared by the Kansas Department of Labor, if applicable.
Full Time Employees:
| Category | Job Title | Salary Range | # of New Employees | # of Transfers | Average Annual Salary | Date Hired |
| Management | ||||||
| Professional | ||||||
| Technical | ||||||
| Clerical | ||||||
| Production/Assembly | ||||||
Part Time Employees:
| Category | Job Title | Salary Range | # of New Employees | # of Transfers | Average Annual Salary | Date Hired |
| Management | ||||||
| Professional | ||||||
| Technical | ||||||
| Clerical | ||||||
| Production/Assembly | ||||||
What are the employer's share of fringe benefits including health insurance but excluding vacation, holidays, and sick leave, as a percentage of annual salary by employee category? Also, indicate the percentage of health insurance cost paid by the employer.
| Category | Fringe Benefit Percentage | Health Insurance % Paid by Employer |
| Management | ||
| Professional | ||
| Technical | ||
| Clerical | ||
| Production/Assembly |
Note: Percentage varies with salary level if all employees receive the same benefit package.
Briefly describe your medical, vacation, sick leave and retirement benefits. (Attach any appropriate benefit summary publications if applicable.)
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Provide a breakdown of your annual operating expenses. Indicate the percentage of total annual operation expenses that will be spent locally within Douglas County for each item.
For firms expanding their facilities and operations in Douglas County, indicate the current annual operating expenses and provide a projection for the incremental expenses after the expansion. For firms planning to newly locate in Douglas County, an accurate projection of future annual operational expenses needs to be provided.
Annual Operation Expenses1
| Type of Expense | Actual2 | Projected Total3 | % Spent in Douglas Co. | |
| $ Amount | $ Amount | Actual % | Projected Total % | |
| Professional Services (legal, accounting, advertising, etc. | ||||
| Business service (training, maintenance) | ||||
| Cleaning Services | ||||
| Transportation | ||||
| Office Supplies | ||||
| Material & Goods | ||||
| Other (Specify) | ||||
Annual Operational Expenses4
| Type of Expense | Actual ($ Amount) | Projected Total ($ Amount) |
| Water & Sewer | ||
| Sanitation | ||
| Electricity | ||
| Gas | ||
| Telephone & Communication | ||
| Insurance | ||
| Other (specify)5 |
Actual Expenses Subtotal $________________________
Please provide reasons why the property tax abatement is considered to be necessary.
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
What improvements or services will need to be provided by the City or County to accommodate this improvement?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
IV. General Conditions
The following general conditions are understood and agreed to by the applicant requesting the abatement:
- 1.The applicant must agree to and reimburse the City for the costs of any legal, financial, or administrative research and work done in reviewing the proposal, preparing other necessary legal documents, and researching the qualifications of the applicant.
- 2. The applicant shall comply with all the requirements of the City's Economic Development Incentives and Tax Abatement Policy, found in Chapter 1, Article 21 of the Lawrence City Code, including the execution of a performance agreement if a property tax abatement is approved by the City Commission.
- 3. The tax abatement must be approved by the State Board of Tax Appeals pursuant to applicable State law.
- 4. The applicant agrees to provide additional information considered necessary by the Public Incentive Review Committee to make a recommendation to the City Commission on granting the property tax abatement and/or issuance of industrial revenue bonds.
- 5. Each business receiving a tax abatement must complete an annual report by March 1 of each year covering the previous calendar year. Any business which has received a tax abatement shall pay an annual renewal fee of $250.00.
- 6. Enclosed is the application fee of $1,000.00 payable to the City of Lawrence, Kansas.
I (we) verify that the above information and assurances made are complete and correct to the best of my (our) knowledge.
| Signature:_______________________________ | Date:__________________________ |
| Printed Name:____________________________ | Title:__________________________ |
| Signature:_______________________________ | Date:__________________________ |
| Printed Name:____________________________ | Title:__________________________ |

