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Get Form BCTA Brownfields Credit Transfer Application For Calendar Year 2011 Or Taxable Year Beginning

Ederal Identification or Social Security number Mailing address City/Town State Name of contact person Telephone E-mail address Zip Type of entity: Corporation Trust Partnership Certificate number issued by DOR Sole proprietorship LLC Nonprofit Other: Certificate expiration date Amount of Brownfields credit in line 1 to be transferred with this application 1 Brownfields credit amount eligible for transfer (amount on line 1 of Form BCC unused by the taxpayer/transferor) . . . . . .

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