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APPLICATION FORMAT - Tax Base Revitalization Account <br />GENERAL INFORMATION <br />1. Applicant: <br />Contact Person: <br />Street Address: <br />City: State: Zip Code:_ <br />Phone: ( ) - FAX: ( ) - <br />Authorized official(s) (Names and titles for contract execution): <br />SITE INFORMATION <br />2. Site Address: <br />City: <br />❑ City is participating in Housing Incentives Program <br />❑ Site is within a tax increment finance district <br />3. Legal description of site: <br />4. Total acres of site: <br />5. Current Property Owner: <br />Street Address: <br />City: <br />Phone: <br />State: Zip Code:_ <br />FAX: ( ) - <br />6. Year current owner assumed possession of this site: <br />7. The current net tax capacity for this parcel is <br />(tax year ) <br />3 <br />