Arkansas Department of Finance and Administration

Act 518 of 2007

Part A (To be completed by geotourism-supporting business)

Name of Business	FEIN of Business
Mailing Address	City	State	ZIP
Physical Address	City	County
Contact Person Name	Phone Number
Estimated Cost of Project	Start Date of Expenditures
Description of facility and of capital expenditures that will be invested in real or personal property used exclusively for geotourism.
(Attached additional information if needed)
Signature of Company Official and Title	Date

Notice to applicant: To receive the income tax credit provided under this program, this application must first be submitted to DFA at the address shown below. Upon approval by the Department of Parks and Tourism, the Department of Finance and Administration will notify the applicant and provide the necessary forms to claim benefits.

To contact the Tax Credits/Special Refunds Section, please call 501-682-7106

Please mail this completed application to: DFA Revenue Division Tax Credits/Special Refunds Section P O Box 1272 (Room 2370) Little Rock, AR 72203

Part B (To be completed by Department of Parks and Tourism)

Name and type of Geotourism attraction to be supported by applicant, e.g., lake, park, etc.
Type of facility, e.g., lodge, dining, guide, etc.
Is business located in unincorporated area or city with population of less than 16,000?	No	Yes
Is business located within 5 miles of National Scenic Byway?	No	Yes

Is business located within 15 miles of public access to navigable river, Arkansas State Park, Arkansas State Game and Fish Commission WMA, or National Wildlife Refuge? No Yes

The Department of Parks and Tourism certifies that the applicant meets the minimum eligibility requirements for benefits under The Delta Geotourism Incentive Act of 2007. If it is discovered at a later date that the applicant has failed to meet any provision set forth in this Act, then the applicant shall be notified of such failure and will be subject to repayment of benefits. Approval of tax credits will be determined by an examination of the business' records by the Department of Finance and Administration.

Approval Signature/Title

Date