450 Columbus Boulevard, Suite 5 | Hartford, CT 06103-1843 | Phone: 860-500-2300
An Affirmative Action/Equal Opportunity Employer An Equal Opportunity Lender
STATE OF CONNECTICUT
Department of Economic and Community Development
Preliminary Questionnaire to Determine Eligibility for
Enterprise Zone Program Incentives
Municipal Officer to check:
Airport Development Zone
Enterprise Zone
Manufacturing Plant Zone
Bioscience Enterprise Corridor Zone
Enterprise Corridor Zone
Qualified Manufacturing Plant
Contiguous Municipality Zone
Entertainment District
Railroad Depot Zone
Defense Plant Zone
_ Knowledge Center EZ
Urban Jobs Program
The responses to the following items are intended to provide the State with basic information
concerning your business and the proposed activity to confirm whether you may qualify for tax
incentives as provided under Sections 12-81(59), 12-81(60) and 12-217(e) of the Connecticut
General Statutes. The benefits under this program are subject to change by the Connecticut General
Assembly. Upon receipt and review of a completed questionnaire, a staff member would contact
you to discuss the program further.
Please be advised that the completion of this form does not constitute a formal application for a
CERTIFICATE OF ELIGIBILITY, which requires more detailed information. This “pre-app” is
intended only to allow the State DECD to make an initial determination concerning your proposal
at the least cost in time and effort to you.
PLEASE RETURN THE COMPLETED QUESTIONNAIRE TO:
Mr. Edward Bona, Enterprise Zone Coordinator (edward.bona@ct.gov; cc: susan.chen@ct.gov)
Connecticut Department of Economic and Community Development (DECD)
450 Columbus Blvd., Suite 5
Hartford, CT 06103-1843
If you have any questions, or need assistance in completing this questionnaire, please call
Mr. Bona at 860-500-2352 or best by email: edward.bona@ct.gov, cc: susan.chen@ct.gov
Thank you for your cooperation.
[1] LEGAL NAME AND MAILING ADDRESS OF THE BUSINESS:
(as recorded with the Secretary of the State’s Business Recording Division)
FEDERAL EMPLOYER I.D. # SIC/NAICS#
450 Columbus Boulevard, Suite 5 | Hartford, CT 06103-1843 | Phone: 860-500-2300
An Affirmative Action/Equal Opportunity Employer an Equal Opportunity Lender
[2] NAME, TITLE AND TELEPHONE NUMBER OF CONTACT PERSON:
[3] ADDRESS AND SIZE (ft², sq. ft., sqft., SF) OF THE FACILITY, OR PORTION
THEREOF, TO BE OCCUPIED:
[4] ACTUAL OR ANTICIPATED DATE OF OCCUPANCY OF THE FACILITY LISTED
ABOVE:
[5] NAME, MAILING ADDRESS AND TELEPHONE NUMBER OF THE OWNER OF
THE FACILITY:
(See Notes 1 & 2 Below)
[6] THE FACILITY WILL BE (please check all applicable):
Construction (new) Expansion purchase**
Construction (renovation)* (see also NOTE 1 below) leasing**
* For substantial renovations, please provide:
(1) the estimated cost of renovation: $
(2) the current assessed valuation of the facility prior to renovation: $
** If new purchase or leasing, additional DECD requirements include:
If the facility has been idle/abandoned/vacant for at least one year, check here.
DECD requires notarized proof of idleness by the Municipality (see Attachment A).
Current assessed value of the space to be acquired: ___________________
The facility will be used for the following purpose(s)check all that apply:
The manufacturing, processing, or assembly of raw materials, parts or
manufactured products;
The significant servicing, overhauling or rebuilding of machinery and equipment
for industrial use;
The distribution in bulk quantities of manufactured products on other than a retail
basis;
Research and development activities directly related to a manufacturing process;
450 Columbus Boulevard, Suite 5 | Hartford, CT 06103-1843 | Phone: 860-500-2300
An Affirmative Action/Equal Opportunity Employer an Equal Opportunity Lender
Other eligible business services, please describe in the box provided:
[7] Briefly describe the activity or activities in which the firm noted in this questionnaire will
be engaged at the location to be occupied.
[8] Current pre-project employment (full time positions):
Estimated number and type of new, permanent full-time employment positions to be
created at the facility over the next 24 months:
Projected new full-time positions in the 1
st
year 2
nd
year
If you would like additional information on State assistance with financing, wage
and or training subsidies, or other business services, please check the box to the
left. A representative from the Connecticut Department of Economic and
Community Development would contact you.
Handwritten signature of Applicant or Preparer
Type or print name of Applicant or Preparer, Title
NOTES
1. Renovation should be a of a nature requiring the issuance of a building permit, and
involve capital expenditures of at least 50% of the assessed value of the facility, or a
portion thereof, prior to its renovation.
2. A leasing agreement must be for a minimum term of five (5) years, and include an option
to renew for an additional five (5) years, an option to purchase the facility at any time after
the initial five-year term, or both. The term of the lease as well as the idleness as well as
the idle requirement may vary for facilities that are located in an enterprise zone.
450 Columbus Boulevard, Suite 5 | Hartford, CT 06103-1843 | Phone: 860-500-2300
An Affirmative Action/Equal Opportunity Employer an Equal Opportunity Lender
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(DECD Rev. 4/26/2018
Attachment A
From: Enterprise Zone Municipality (CGS. Sec. 32-70 et seq.)
To: Connecticut Department of Economic and Community Development
Date:
Re: Idleness Waiver (Abandoned, Underutilized, or Vacant)
for preliminary application
I certify that the location listed below in
(Municipality)
has been abandoned, underutilized, or vacant for one year (type full address):
CT
Authorized individual attesting to the truthfulness of the statement above, check one:
Assessor
Chief Elected Official
EconDevpt/EZ Coordinator
Handwritten signature:
Type/print name, title:
JURAT
State of Connecticut
County of
Subscribed and sworn to before me (print name)
on this
day of
, 20
(Notarial seal)
Signature of notary public/Commissioner of the Court
My commission expires:
450 Columbus Boulevard, Suite 5 | Hartford, CT 06103-1843 | Phone: 860-500-2300
An Affirmative Action/Equal Opportunity Employer An Equal Opportunity Lender
NOTE to preliminary application “Attachment A” (Idleness Waiver Memorandum)
In the Connecticut General Statutes, “abandoned,” “underutilized,” and “vacant” appear as follows:
Sec. 32-70. Enterprise zones. Designation. Expansion. ...include in such zone any
property …that is or was formerly used for manufacturing purposes but is underutilized or
vacant at the time the property is included in such zone….”
Applies to EZ: Bridgeport, Bristol, East Hartford, Groton, Hamden, Hartford, Meriden,
Middletown, New Britain, New Haven, New London, Norwalk, Norwich, Southington,
Stamford, Thomaston, Waterbury, Windham.
Sec. 32-75a. Railroad depot zones. Regulations. A municipality which has an enterprise
zone designated under section 32-70 and an abandoned or underutilized railroad depot
which is located outside of the enterprise zone may,…
Applies to RDZ: East Hartford, Hamden, and Norwich.
Sec. 32-75c. Designation of properties as manufacturing plants. Qualified
manufacturing plants. Regulations. (3) includes at least one hundred acres of land that
is vacant and zoned for commercial, industrial or other economic base activity….”
Applies to DPZ, MPZ, QMP: Bristol, New Britain.
The Attachment A “idleness waiver” for abandoned, underutilized, or vacant properties is optional
and does not apply to the following preliminary applications (pre-apps):
ADZ (Bradley, Groton-New London, Waterbury-Oxford), BCZ, CMZ, ECZ, ED, UJ.
Current DECD-approved zones and DECD abbreviations
_ Airport Development Zone
(ADZ)
_ Bioscience Enterprise Corridor Zone
(BCZ)
_ Contiguous Municipality Zone
(CMZ)
_ Defense Plant Zone
((DPZ)
_ Enterprise Zones
(EZ)
_ Enterprise Corridor Zones
(ECZ)
_ Entertainment Districts
(ED)
_ Manufacturing Plant Zone
(MPZ)
_ Qualified Manufacturing Plant
(QMP)
_ Railroad Depot Zone
(RDZ)
_ Urban Jobs Program
(UJ)
(DECD Rev. 05/01/2018)
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