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Liberty Hill Economic & Fiscal Impact Project Data Sheet

The information requested on this form will be used by the Liberty Hill Economic Development Corporation to prepare an impact analysis of your firm or project. Submittal of this form does not imply the approval of any incentives from the Corporation or the City. Any incentives must be considered and approved by the EDC Board and the City Council in public meetings.

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"*" indicates required fields

Basic Information

Name of Business*

Project Address*

Street Address Address Line 2 City State ZIP Code

Business Website (optional)

Point of Contact Name*

First Last

Point of Contact Phone*

Point of Contact Email*

Company CEO or President (if different from Point of Contact)

First Last

Company CFO (if applicable)

First Last

Company HR Executive (if applicable)

First Last

Is your company registered to do business in Texas?*

Yes

How long has the company been in operation?*

Number of employees in State*

Number of employees in US*

Number of employees worldwide*

Required Preliminary Questions

In order to qualify as a Project, under the Texas Economic Development Sales Tax Act, you need to be able to answer YES to following questions:

Are the jobs available at a company for which a majority of the products are services of that company are marketed beyond Liberty Hill to regional, statewide, national, or international markets infusing new dollars into the local economy?*

Yes

Are the jobs included in one of the NAICS Codes set forth in the Act listed below?*

Yes

111 Crop production 112 Animal production 113 Forestry and logging 11411 Commercial fishing 115 Support activities for agriculture and forestry 211-213 Mining 221 Utilities 311-339 Manufacturing 42 Wholesale Trade 48-49 Transportation and warehousing 51 Information 523-525 Securities, commodity contracts and other financil investment and related activities; insurance carries and related activities; funds, trusts, and other financial vehicles 5413 Architectural, engineering, and related services 5415 Computer system design and related services 5416 Management, scientific, and technical consulting services 5147 Scientific research and development services 5419 Other professional, scientific, and technical services 551 Management of companies and enterprises 56142 Telephone call centers 928110 National Security

To help identify the correct industry code: http://www.census.gov/cgi-bin/sssd/naics/naicsrch?chart=2012

The Company's primary North American Industry Classification System (NAICS):*

If unsure, please explain what services or products the company produces or services:

Is the Project suitable for the development, retention, or expansion of any of the following?

Manufacturing and industrial facilities

Research and development facilities

Military facilities

Transportation facilities, including airports, hangars, and rail ports

Recycling facilities

Distribution centers

Small warehouse facilities

Primary job training facilities for use by institutions of higher learning

Regional or national corporate headquarters facilities (defined to mean buildings proposed for construction or occupancy as the principal office for a business enterprise's administrative and management services)

Background and Requirements

Enter any information that you would like us to know about your requirements or intent for the economic analysis. Please describe any incentives that you would like us to model in the analysis.

Project Information

Name of the Project*

Location of the Project*

Will you own or lease the facility*

Own

Lease

If lease, please provide anticipated length of time in lease agreement:

Anticipated site selection decision date:

Anticipated date to breakground / lease by:

Anticipated completion date:

Anticipated size of facility:

Has the company been involved in any local, state or Federal investigations and/or lawsuits pertaining to the operation of the organization?*

Yes

Have you had any previous business activity in the State?*

Yes

If yes, where?

Job Information

Workers relocating year by year

Add rows as needed for years in business, and list the amount of workers relocated in that year in the column on the right.

Year in Business (1, 2, 3, etc.)

Workers Relocated

Percent of New Direct Workers moving to Liberty Hill*

Please enter a number less than or equal to 100.

Average annual salaries of new employees each year

Add rows as needed for years in business, and list the average annual salary of new employees in that year.

Year in Business (1, 2, 3, etc.)

Average Annual Salaries

Percent of average annual salary increase*

Please enter a number less than or equal to 100.

Benefits Offered

Paid Time Off

Health Insurance

Other Insurance (Dental, Vision, Life, or Disability)

Retirement

Tuition Reimbursement

Capital Investment

Add rows as needed for years in business on the left, and list the capital investment in the appropriate columns on the right

Year in Business (1, 2, 3, etc.)

Land

Buildings and other Real Property Improvements

Furniture, Fixtures, and Equipment

Total Capital Investment

Enter the total Capital Investment from the fields above.

Are the building and improvements costs entered above for construction?

Yes

Building permits and fees to be paid to the City during construction, if applicable

Add rows as needed for years in business, and list the total City building permits and fees paid in that year.

Year in Business (1, 2, 3, etc.)

Total City Building Permits and Fees

Overall Total City Building Permits and Fees

Enter the Overall Total Building Permits and Fees paid to the City

Estimated taxable inventories at the end of each year

Add rows as needed for years in business, and list the Estimated taxable inventories at the end of each year

Year in Business (1, 2, 3, etc.)

Total Inventories

Percent of average annual increase

Enter the percent of the annual increase for the field above

Please enter a number less than or equal to 100.

The Project's estimated taxable purchases of materials, supplies, and services in the community and the Project's estimated taxable sales that will be subject to sales taxes in the community

Add rows as needed for years in business on the left, and enter the relevant amounts in the appropriate columns on the right

Year in Business (1, 2, 3, etc.)

The Project's Taxable Purchases

The Project's Taxable Sales

Taxable Purchases percent of average annual increase

Enter the percent of the annual increase for the field above

Please enter a number less than or equal to 100.

Taxable Sales percent of average annual increase

Enter the percent of the annual increase for the field above

Please enter a number less than or equal to 100.

Tell us more about the project-- Select all that apply to the Project

Corporate Headquarters

Regional Headquarters

Office

Call Center

Data Center

Laboratory/Research

Industrial-Manufacturing

Industrial - Distribution

Other

If other, explain:*

Is there any additional information you would like us to consider?

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Liberty Hill Economic & Fiscal Impact Project Data Sheet

Basic Information

Required Preliminary Questions

Project Information

Job Information

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