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2. Application for residential Community Reivestment Area Tax Incentives from the City of North Canton, Stark County, Ohio.
4. Applicant / Property Owner Information
6. Name*
8. Address*
10. City*
11. State*
12. Zip Code*
14. Phone Number*
15. Email Address*
17. Project Site Information
19. Contact Person (If different from above)
21. Phone Number
22. Email Address
24. Address (If different from above)
26. City
27. State
28. Zip Code
30. Does the property owner owe:
32. Deliquent Taxes to the State of Ohio or any political subdivision thereof?*

    1. Yes
    2. No
33. Any monies to the State or a State agency for the administration or enforcement of any environmental Laws?*

    1. Yes
    2. No
34. Any monies to the State, political subdivision thereof, or a State agency that are past due?*

    1. Yes
    2. No

    Whether such amounts are contested in a court of law or not.
36. If yes to any of the above, please provide details of each instance including, but not limited to, the location, amounts and/or case identification numbers.
    Supporting documents may be attached below.
38. Briefly describe the nature of improvements made.*
40. Project was completed on:*
    Project was completed on:
42. Please state the total value invested in improvements in USD.
43. Total*
45. Amount spent on demolition*
46. Amount spent on additions/new construction*
47. Amount spent on internal improvements*
    (furniture and fixtures or landscape improvements)
49. Assessed property value prior to improvements:*
50. Assessed property value after improvements.*
52. Please attach a property tax assessment from prior to improvements from the Stark County Auditor.*
53. Please attach a current property tax assessment from the Stark County Auditor.*
55. Please attach documention of your expenses.*
    Attach all receipts, invoices, etc. as one document.
56. Attach here any other additional documentation you wish to provide.
58. Agreements
    As part of this application, the property owner may also be required to directly request tax records from the Ohio Department of Taxation, or complete a waiver form allowing the Department of Taxation to release specific tax records to the local jurisdiction considering the request.
60. The Applicant agrees to supply additional information upon request.
62. The Applicant affirmatively covenants that the information contained in and submitted with this application is complete and correct and is aware of the ORC Sections 9.66(C) (1) and 2921.13(D) (1) penalties for falsification which could result in the forfeiture of all current and future economic development assistance benefits as well as a fine of not more than $1,000 and/or a term of imprisonment of not more than six months.
64. Name of Property Owner*
65. Date*
    Date
67. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
69. Signature
71. Satements of Compliance with Local and State Law
    A copy of this proposal will be forwarded by the City of North Canton to the affected Board of Education along with the final agreement.
73. Please note that copies of this proposal must be included in the finalized Community Reinvestment Area Agreement as "Exhibit A" and be forwarded to the Ohio Department of Taxation and the Ohio Development Services Agency within fifteen (15) days of final approval.
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75. 1. Receive an email copy of this form.
76. Email address

    This field is not part of the form submission.

77. Submit Submit and Print

* indicates a required field