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Click ‘Get Form’ to open the OMB CONTROL NUMBER: 1651-0086 in the editor.
Begin by filling out the Claimant's Information section. Enter your name as it appears on official documents, followed by your mailing address, including city, state, and zip code. If applicable, check the box for PO Box.
Provide your business type by selecting one from Sole Proprietorship, Partnership, or Corporation. Then enter the appropriate identification number based on your selection.
In the Contact Information section, fill in details for a primary contact person including their name, email, phone, and fax numbers. If their address differs from the claimant's mailing address, provide that information as well.
Complete the Federal Register Notice Information section by entering relevant dates and answering questions regarding your eligibility as a successor company or member of an association.
Fill out previously certified qualifying expenditures for all filing years and ensure all amounts are accurately reported.
Finally, review the Statement of Eligibility and Certification sections carefully before signing. Ensure all information is true and accurate before submitting.
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