Application Form

How many employees are anticipated to be retained as a direct result of this abatement?

Wages and Benefits:

What is the starting hourly wage? $ 16.00

High Wage: $ 33.00

Average Wage: $ 23.64

What is the expected average hourly wage for the jobs resulting from this abatement?

$ 18.00-21.00

What is the required skill level of new employees? setup/prog- high skill; operator is low

Does the company offer health insurance? Yes No

If "yes", what percentage is paid from the:

Employer 30 % and Employee 70 %

Does the company offer retirement benefits (e.g. pension plan, 401k, etc.)?

Yes No If "yes", what percentage is paid from the:

Employer 2.5 % and Employee 97.5 %

Does the company pay for any training or continuing education? Yes No

If "yes", please explain: in-house as needed and continuously

Please include with this application a map identifying the general location of the investment and a non-refundable check for $250 made payable to the Delaware County Treasurer.

I hereby certify that the information and representations on this application are true and complete. By signing below I accept responsibility of the representations above and I hereby acknowledge that this form will become public record. Furthermore, I understand and am aware that by requesting this abatement, I am responsible for annually filing a CF-1 (Compliance with Statement of Benefits), Form 322 ERA/PP (Application for Deduction from Assessed Valuation), and Form SB-1/PP by the dates indicated on the forms in order to actually receive the tax deduction.