5. Tax Declaration Form Template.cleaned.pdf
PDF 232 KB Posted
- Solicitation number
- 145995
- Issued by
- Hartford County, Connecticut
About this file
This is a Tax/Financial Certification and Declaration Form issued by the City of Hartford, Connecticut, for use by applicants responding to requests for proposals (RFPs). The form requires applicants to provide identifying information including owner name, business name, date of birth, Federal Employer ID number, and contact details. Applicants must disclose the form of business organization, whether sole proprietorship, corporation, partnership, LLP, or LLC, and list the names of principals if applicable. The form requires declaration of any delinquencies across multiple categories including real, personal, and vehicle taxes; City of Hartford loans; rental payments; police private duty services; fire watch services; false alarm fees; license, inspection, and permit fees; special event services; and housing and building code violations. Applicants must provide explanations for any delinquencies indicated.
The form also requires applicants to declare their property ownership status in Hartford, including personal property, business personal property, motor vehicles, and real estate. Applicants must disclose whether they have registered motor vehicles in Hartford or received tax bills from the city, and whether their business is registered with the Hartford Assessor's Office. Supporting documentation is required, including copies of current paid tax bills accessible through the city's online tax bill portal. The form must be completed, signed, and dated by an authorized representative with printed name and title, serving as a prerequisite for participation in the City of Hartford's procurement process for the Architectural and Engineering Services with Landscape Design project for Colt Park Carriage House and Gardener's Cottage Structural Stabilization.
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Text version
CITY OF HARTFORD TAX/FINANCIAL CERTIFICATION AND DECLARATION FORM
To Be Completed by Applicant
Name of Owner: Business Name:
Date of Birth: mm/dd/year Federal Employer ID #
Home Address: Business Address:
City, State, Zip City, State, Zip
Contact # Business Contact #
RFR Number RFR Tittle
Form of Business:
☐ Sole Proprietorship ☐ Corporation ☐ General Partnership ☐ Limited Partnership ☐ LLP ☐ LLC
IF SOLE PROPRIETORSHIP OR PARTNERSHIP, LIST THE NAMES OF THE PRINCIPALS OF THE ORGANIZATION:
Property Declaration of Delinquencies - for each of the categories below, please indication whether your organization is delinquent on required payments to the City of Hartford. If yes, please provide an explanation.
Categories Yes No Taxes (real, personal, vehicle) Loans received through the City of Hartford Rental Payments Police private duty service Fire watch service False alarm fees License & inspection & permit fees Special event services Housing and building code violations
IF “YES” TO ANY OF THE ABOVE, PROVIDE AN EXPLANATION.
CITY OF HARTFORD TAX/FINANCIAL CERTIFICATION AND DECLARATION FORM
Declaration of Property
1 Do you currently own property in the City of Hartford? (Personal Property (Business Personal Property), Motor Vehicle or Real Estate)
Yes No
2 Have you ever registered a motor vehicle in Hartford? If “YES” (Submit a copy of your most current paid bill. (https:www.mytaxbill.org/inet/bill/home.do?town=hartford))
3 Have you ever been issued a tax bill from the City of Hartford?
4 Is your business registered with the Hartford Assessor’s Office? If “YES” (Submit a copy of your most current paid bill. (https:www.mytaxbill.org/inet/bill/home.do?town=hartford))
Authorized Signature Print Name and Title Date (MM/DD/YEAR)
File details come from the government source that posted it. Updated .