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2009
Early Election LIHC Massachusetts
Low-Income Housing Department of
Revenue
Credit Notification
For calendar year 2009 or taxable year beginningand ending
Name of project owner Social Security or Federal Identification number
Street address City/Town StateZip
Name of project Building identification number
Street address City/Town StateZip
The undersigned is electing to make an early credit election of the Massachusetts low-income housing credit and is notifying the Department of Revenue of
this election pursuant to 760 CMR 54.09(3) and 54.09 (4).
Signature of project owner Date
Name of contact person Telephone number
Mail completed form to: Massachusetts Department of Revenue, Audit Division, 200 Arlington Street, Room 4300, Chelsea, MA 02150, Attn.: Low-
Income Housing Unit.
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