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i <br /> i <br /> UST.CLAIM APPLICATION <br /> INSTRUCTIONS FOR PAGE SEVEN <br /> II - <br /> IX. PRIORITY CLASS DESIGNATION (Continued) <br /> Class B - Small Business - If claiming Priority Class B, Small Business; check this box. ALL of the following <br />{ areas must be completed. Refer to Program Information, Priority Classes, for the criteria that must be met to a <br /> claim this class. <br /> Once you have completed this section, refer to the maximum receipt's amount you have completed in ".K" to <br /> see if your total is less than the maximum receipts specified for your ; <br /> type of business. If you have exceeded <br /> the maximum gross receipts allowed, you do not qualify for Priority Mass B. <br /> i ' <br /> A. Identify the claimant's business name. <br /> B. Specify the claimant's business (i.e., gas station, real estate). II <br /> � t <br /> C. List the dates of when the claimant's business operations began and, if no longer in operation, the date <br /> t <br /> the business ceased operations. <br /> t <br /> D. List the address where the principal business office is located:) <br /> r E. Check the appropriate boxes in response to the four questions. <br /> F. Check the box indicating the category for this type of business. <br /> fi. <br /> G. Using Attachment B, Gross Revenue Chart, specify the Industry Group/License Type for the claimant's <br /> business. <br /> f . <br /> H. Using Attachment B, Gross Revenue Chart, specify the titaximum Receipt Amount for the claimant's <br /> business. <br /> NOTE: Only one industry/amount on the Gross Revenue Chart can b'' used; do not combine the amounts of <br /> two separate industries. Example 1 - The owner or operator of a service station would identify the type of j <br /> business as Non-manufacturer, Industry Group xxxv (Petroleum Produ'cts), with a maximum receipts amount for <br /> the three ,years of 521,000,000. Example 2 - Where the claimant is tfIe owner of a UST located on property <br /> which has been leased or rented or otherwise held for profit, and where the owner or operator has not <br /> operated any business at the site on or after the date of the release. I'n such case, the type of business would be <br /> identified as Service, Industry Group ix(1) (Real Estate Operators), with a maximum receipts amount for the <br /> i <br /> three years of$3,000,000. 9 <br /> { <br /> I. Check the appropriate box to indicate the claimant's type of ownership. <br /> i <br /> ). List the name, location and relationship of all affiliated comp Inies or other income producing units <br /> (i.e., parent company subsidiary, franchise, branch). j <br /> K. Specify the annual receipts for the three most recently completed fiscal years and the total receipt= for <br /> those years. <br /> Class B - Local Governmental Entities and Nonprofit Organizations- If claiming Priority Class B as a.local <br /> governmental entity or a nonprofit organization, check this box. All of the following must be completed. Refer <br /> to Program Information, Priority Classes, for the criteria that must be 'met to claim this class. <br /> I. <br /> A. Check the appropriate box to identity the claimant's status. <br /> B. List the total annual revenues and identify for which fiscal year ending. I <br /> I <br /> <I <br />