26 CAR pt. 71, Appendix A. Application for Delta Geotourism Incentives

Arkansas Department of Finance and Administration APPLICATION for DELTA GEOTOURISM INCENTIVES Act 518 of 2007 Part A (To be completed by geotourism-supporting business) Name of Business FEIN of Business Mailing Address City State ZIP Physical Address City County Contact Person Name Phone Number Estimated Cost of Project Start Date of Expenditures Description of facility and of capital expenditures that will be invested in real or personal property used exclusively for geotourism. (Attached additional information if needed) Signature of Company Official and Title Date Notice to applicant: To receive the income tax credit provided under this program, this application must first be submitted to DFA at the address shown below. Upon approval by the Department of Parks and Tourism, the Department of Finance and Administration will notify the applicant and provide the necessary forms to claim benefits. To contact the Tax Credits/Special Refunds Section, please call 501-682-7106 Please mail this completed application to: DFA Revenue Division Tax Credits/Special Refunds Section P O Box 1272 (Room 2370) Little Rock, AR 72203 Part B (To be completed by Department of Parks and Tourism) Name and type of Geotourism attraction to be supported by applicant, e.g., lake, park, etc. Type of facility, e.g., lodge, dining, guide, etc. Is business located in unincorporated area or city with population of less than 16,000? No Yes Is business located within 5 miles of National Scenic Byway? No Yes Is business located within 15 miles of public access to navigable river, Arkansas State Park, Arkansas State Game and Fish Commission WMA, or National Wildlife Refuge? No Yes The Department of Parks and Tourism certifies that the applicant meets the minimum eligibility requirements for bene under The Delta Geotourism Incentive Act of 2007. If it is discovered at a later date that the applicant has failed to m any provision set forth in this Act, then the applicant shall be notified of such failure and will be subject to repaymen benefits. Approval of tax credits will be determined by an examination of the business’ records by the Departmen Finance and Administration. Approval Signature/Title Date