TC-AQ DIVISION OF AIR QUALITY TAX CERTIFICATION & EXEMPTION APPLICATION PAGE 2 Equipment: Equipment must be used exclusively for the abatement of air pollution. Revised 05/18/2016 For DAQ Original Permit Is this Description of Air Pollution For Use Only. Asset Number, % of Use Application Date Original asset Vehicle How is this equipment used for air pollution for Year County “A” Control Devices as Listed on AND Current Historical replacing Identification abatement? Pollution Acquired Use Approved Control Device ID Cost* a prior the Current Air Permit** Only Number (VIN) Abatement “D” No. asset? Disapproved 1 2 3 4 5 6 7 8 9 10 Attach additional pages if necessary DAQ Review Engineer (Print) ____________________________ Signature: ________________________________ Date: ___________ TC-AQ
TC-AQ DIVISION OF AIR QUALITY TAX CERTIFICATION & EXEMPTION APPLICATION PAGE 2 Equipment: Equipment must be used exclusively for the abatement of air pollution. Revised 05/18/2016 For County Use Only For DAQ Use Only. “A” Approved “D” Disapproved Description of Air Pollution Control Devices as Listed on the Current Air Permit** Original Permit Application Date AND Current Control Device ID No. Asset Number, Vehicle Identification Number (VIN) How is this equipment used for air pollution abatement? % of Use for Pollution Abatement Year Acquired Original Historical Cost* Is this asset replacing a prior asset? 1 2 3 4 5 6 7 8 9 10 Attach additional pages if necessary DAQ Review Engineer (Print) ____________________________ Signature: ________________________________ Date: ___________ TC-AQ
Tax%20Certification%20Application%20Form%2020160518.docx