City of Philadelphia-Tax Subsidy Self-Reporting Form

Primary Business Contact Information

In accordance with Bill #160015, approved by Philadelphia City Council and signed by Mayor Kenney on September 15, 2016, the Department of Commerce has developed the following self-reporting form to collect economic development and job creation data from Philadelphia businesses subject to the aforementioned legislation.

This bill requires reporting by businesses that: 1) receive $50,000 or more in financial assistance or subsidies (in the previous calendar year) originating from public dollars, such as federal, state, or city funds operated through city or quasi-city agencies in Philadelphia; or 2) are located in a KOZ and have $2 million or more in gross revenues.

The following is a link to the legislation: Bill #160015. The deadline for reporting is May 1st.

Question Title

* 1. Please provide the primary contact information of the business, located in the City of Philadelphia, which received a subsidy of $50,000 or more during the previous calendar year.

Business Name:

Business Address:

Business Phone Number:

Business Contact Name:

Business Contact Title:

Business Contact Email Address:

Business Contact Phone Number:

14% of survey complete.