Venture Portfolio
Meet Our Team
Learn About CI
Who We Are
Venture Portfolio
Successful Exits
Case Studies
Meet Our Team
Financial Information
Talent Acquisition
Press
Governance
RFPs/RFIs/Notice of Public Hearings
Obtain Funding
Funding Opportunities
Angel Investor Tax Credit Program
SSBCI Technical Assistance Program
Investors
Investment Strategy
Venture Portfolio
Meet Our Team
Explore Connections
Access Content Library
Job Seekers
Connect With Us
Angel Investor Tax Credit Application
Qualification Requirements
Are you an accredited investor as defined by the Securities and Exchange Commission?
(Required)
Yes
No
The definition of an acccredited investor, as defined by the Securities and Exchange Commission or network of accredited investors who review new or proposed businesses for potential investment and who may seek active involvement, such as consulting and mentoring, in a Connecticut business.
Do the person(s) reserving the tax credit currently own 50 percent or more of the Qualified Connecticut Business in which they are investing?
(Required)
Yes
No
If no, what percentage of the Qualified Connecticut Business do they currently own (if any)?
Thank you for your interest in the Angel Tax Credit Program. Based on your answer, you are not eligible at this time.
Name of Accredited Investor or Entity:
(Required)
Address
(Required)
Street Address
Address Line 2
City
ZIP / Postal Code
Contact name
(Required)
First
Last
Phone
(Required)
Email
(Required)
SSN or FEID no.
(Required)
Name of Qualified Connecticut Business
(Required)
Amount of investment-
(Required)
Please enter a number from
25000
to
400000
.
Must be at least $25,000 and not exceed $400,000 and made in cash. Proof of investment must be submitted to Connecticut Innovations prior to issuance of Angel Investor Tax Credit.
Angel investor tax credit requested (25% of cash investment). Maximum credit available to any one angel investor shall not exceed $500,000. The credit shall be claimed in the taxable year in which the investment is made.
Are you bearing all of the risk of loss in this investment?
(Required)
Yes
No
Type of qualified security to be issued
(Required)
General Partnership Interest
Limited Partnership Interest
Common Stock
Preferred Stock (must be convertible to common stock)
Other form of Equity
Please describe any other forms of equity
(Required)
Expected date of investment in Qualified Connecticut Business
(Required)
MM slash DD slash YYYY
Consent
(Required)
I agree to the privacy policy.
The undersigned acknowledges and agrees that
1. Connecticut Innovations, Incorporated (“CI”) and the State of Connecticut (a) have not endorsed or recommended an investment in the issuer; (b) have not made any representation or warranty of any kind with respect to the value of the issuer’s securities, the financial condition or the future earnings of the issuer, the management of the issuer or the issuer’s business or prospect; and (c) will bear no responsibility for any investment losses or other damages that may be suffered as a result of an investment in the issuer.
2. The listing by CI of the Issuer as a “Qualified Connecticut Business” means only that CI has determined, based solely on information provided by the issuer, that the issuer meets the statutory requirements for approval as a Connecticut business qualified to receive cash investments eligible for a Connecticut income tax credit pursuant to the Public Act (the “Act”). The availability, amount and value of such a tax credit to a particular taxpayer is a function of other provisions of the Act and the taxpayer’s own individual tax situation, as to which the undersigned should look to their own tax advisor for advice.
3. CI is a “public agency” for purposes of the Connecticut Freedom of Information Act (“FOIA”). Accordingly, upon receipt at the office of CI, any application under the Connecticut Angel Investor Tax Credit Program will be considered a public record or file subject to disclosure under the FOIA. The FOIA includes exemptions for “trade secrets” and “commercial or financial information given in confidence, not required by statute.” In addition, all financial and credit information and all trade secrets contained in an application for financial assistance or obtained by CI concerning any applicant for financial assistance or any project, activity, technology, product or invention is exempt from disclosure under FOIA. Only the particular information falling within one of these exemptions can be withheld by CI if made the subject of a public records request under FOIA. Therefore, an applicant under the Connecticut Angel Investor Tax Credit Program should specifically identify those particular sentences, paragraphs, pages, sections or exhibits that it claims to be exempt. Applicants should be aware that (i) CI has no obligation to notify any applicant of any FOIA request received by CI; (ii) CI may disclose materials claimed to be exempt if in its judgment such materials do not appear to fall within a FOIA exemption; (iii) CI may in its discretion notify applicants of FOIA requests and/or of complaints made to the Freedom of Information Commission concerning items for which an exemption has been claimed, but CI has no obligation to initiate, prosecute or defend any legal proceeding or to seek to secure any protective order or other relief to prevent disclosure of any information pursuant to an FOIA request, (iv) the applicant will have the burden of establishing the availability of any FOIA exemption in any such legal proceeding, and (v) in no event shall CI or any of its officers, directors or employees have any liability for disclosure of documents or information in the possession of CI which CI, or such officer, director or employee, in good faith believes to be required pursuant to the FOIA or other requirements of law. In the event of a public records request for an application under the Connecticut Angel Investor Tax Credit Program, CI may request, and each applicant agrees promptly to provide to CI, a version of such application from which all information for which an FOIA exemption has been claimed has been redacted. Except for trade secret or other proprietary information identified as such pursuant to the section above dealing with the Freedom of Information Act, CI is not restricted in its right to use or disclose any or all of the information contained in any application and can do so without compensation to the applicant, notwithstanding any language in the application to the contrary.
Signature
(Required)
Printed name of above signer
(Required)
Angel Investor Tax Credit Reservation Numbers are issued on a first come, first serve basis based upon the date that Connecticut Innovations receives this application, not based on the date the investment is made by the investor.
CAPTCHA
Δ