Application for Historic Preservation Tax Credit
Owner’sName_______________________________________________________
Owner’sMailingAddress_______________________________________________
Addresswheretheworkwascompleted______________________________________
DaytimeTelephoneNumber_____________________________________________
CellPhonenumber____________________________________________________
EmailAddress________________________________________________________
PropertyTaxAccountNumber________________________________________________________
I. ThepropertyislistedintheMasterPlanforHistoricPreservationas:
taxcredit?
Ifso,pleaseattachacopyofyourcompleteapplication.
II. InaccordancewithChapter52,ArticleVI,oftheMontgomeryCountyCode,Irequestacreditto
mycountypropertytaxesforthefollowingwork:
Restorationandpreservationworkatanindividuallydesignatedhistoricsiteoran
historicresourcewithinanhistoricdistrictthatwasthesubjectofanapprovedHistoricArea
WorkPermit(HAWP)andqualifiesunderChapter52,ArticleVI.
OrdinaryMaintenanceonahistoricsiteorhistoricresourcewithinanhistoricdistrict
wheretheamountexpendedexceeds$1,000.
III. I have read the attached guidance on how to apply and the Helpful Guidance and Tips for Complete
Tax Credit Packages; have completed my application package including all attachments; and
have completed and signed the Receipts Transmittal Form.
SiteNameorHistoricDistrict:____________________________
HaveyouappliedforordidthisprojectreceiveaHistoricAreaWorkPermit?
Yes
Ifso,pleaseattachacopyofyourapprovalmemofromtheHistoricPreservationOfficeor
theDepartmentofPermittingServices.
DidyouapplyforordidthisprojectreceiveaMarylandstateorfederalhistoricpreservation
Yes
No
No
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Date
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