The following must be submitted to complete application:
Copy of script & synopsis, or a commercial story board, or documentary outline/treatment
Full budget with top sheet
Signed application form
Type of Production (Pick one)
Company to Receive Rebate and Tax Reductions (The company that will be receiving invoices.) NOTE: Federal Tax ID must match to recieve rebate.
Other Contact Information
Proposed Dates of Work
Estimate your MS expenditures:
Note: (a) + (b) + (c) = Total MS Budget
Note: (d) + (e) + (f ) = Anticipated Rebate
Intended Plan for Distribution (check all that apply)
I attest this production company does not include any company-owned, affiliated, or controlled, in whole or in part, by any company or person which is in default on a loan made by the state or a loan guaranteed by the state, or any company or person who has ever declared bankruptcy under which an obligation of the company or person to pay or repay public funds or monies was discharged as a part of such bankruptcy.
Please be advised that making false representations and/or submitting falsified documents to either the Mississippi Development Authority or the Mississippi Department of Revenue with an intent to defraud the state is a crime and may lead to both civil and criminal penalties. Miss. Code Ann. § 97-7-10 states, “Whoever, with intent to defraud the state or any department, agency, office, board, commission, county, municipality or other subdivision of state or local government, knowingly and willfully falsifies, conceals or covers up by trick, scheme or device a material fact, or makes any false, fictitious or fraudulent statements or representations, or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry, shall, upon conviction, be punished by a fine of not more than Ten Thousand Dollars ($10,000.00) or by imprisonment for not more than five (5) years, or by both such fine and imprisonment.”