MARYLAND CYBERSECURITY INVESTMENT INCENTIVE TAX …

1 MARYLAND CYBERSECURITY INVESTMENT INCENTIVE TAX CREDIT application for certification For Internal Use Legal Name of Tax Form of EntityLLC LLP Limited Partnership General Partnership Trust Other (specify): Contact PersonLast Name Suffix (Jr., Sr., III) First Name Middle Name Title/ Occupation Main Telephone (Include Area Code) Business Telephone (include Area Code) Email Address Contact PersonLast Name Suffix (Jr., Sr., III) First Name Middle Name Title/ Occupation Main Telephone (Include Area Code) Business Telephone (include Area Code) Email Address AddressCity State Postal Code FORM NON SUB-CHAPTER S CORPORATION pass - through ENTITIES application for certification -TAX YEAR 20__ or for Fiscal Year Taxpayers, Tax Year IMPORTANT Because the MARYLAND CYBERSECURITY INVESTMENT Tax Credit is limited and capped, applications are accepted on a first come, first served basis.

2 Signature(s) required. WARNING: False statements made knowingly and willfully in this tax credit application, including affidavits or other supporting documents submitted therewith, are punishable by law. All statements and documents are subject to verification. *Applicants sh ould be aware t hat all information submitted in or accompanying an application may be subject to the provisions of theMaryland Public Information Act (Md. Code, State Government Article, Title 10, Subtitle 6, Part III) and to the provisions of Md. Code, Tax General Article, 10-733(i). Page 1 of 4 MARYLAND CYBERSECURITY INVESTMENT INCENTIVE TAX CREDIT application for certification FORM NON SUB-CHAPTER S CORPORATION pass - through application for certification -TAX 2 0__ or for Fiscal Year Taxpayers, Tax Year ____IMPORTANT Because the MARYLAND CYBERSECURITY INVESTMENT Tax Credit is limited and capped, applications are accepted on a first come, first served basis.

3 Signature(s) required. Amount$ - Please attach the following i nformation to y our A certified copy of organization s articles of incorporation, articles of organization, partnership agreements, declaration of trust, will or other organizing documents certified within the last 30 days. For a corporation or limited liability company, a current certificate of good standing, having been issued within the last 30 days, from the MARYLAND State Department of Assessments and Taxation (only for corporations qualified or organized in the State of MARYLAND ). For other foreign entities, file a certificate of status issued within the last 30 days from the state/jurisdiction of organization.

4 The names and business addresses of all officers, directors, managing members, general partners, or other persons with management authority over the business of the applicant as the case may be. The name, address and percentage of ownership of each person or entity who or which holds equity interests in the applicant of any class or classes that constitute five percent (5%) or more of t he total equity capital o f t he applicant. InformationHas the Applicant, or any partner, director, officer, member, or principal stockholder: Been convicted of a criminal offense other than a tr affic violation? Yes No Been a debtor in bankruptcy or insolvency proceedings?

5 Yes No Been a party to any litigation in the past two years? Yes No Does the Applicant, or any partner, director, officer, member, or principal stockholder: Owe any outstanding judgments? Yes No Owe any delinquent taxes? Yes No *Applicants sh ould be aware t hat all information submitted in or accompanying an application may be subject to the provisions of theMaryland Public Information Act (Md. Code, State Government Article, Title 10, Subtitle 6, Part III) and to the provisions of Md. Code, Tax General Article, 10-733(i). Page 2 of 4 MARYLAND CYBERSECURITY INVESTMENT INCENTIVE TAX CREDIT application for certification FORM NON SUB-CHAPTER S CORPORATION pass - through application for certification -TAX 2 0__ or for Fiscal Year Taxpayers, Tax Year ____IMPORTANT Because the MARYLAND CYBERSECURITY INVESTMENT Tax Credit is limited and capped, applications are accepted on a first come, first served basis.

6 Signature(s) required. 11 .Provide the percentage of ownership in the proposed Qualified MARYLAND CYBERSECURITY of QMCC/Company: Before the proposed acquisition of ownership % After the proposed acquisition of ownership % and SignatureUnder penalties of perjury, I declare that I have examined this applicatio n, and to the best of my knowledge and belief, it is tr ue, correct, and accurately lists the amount of investments during the tax year. X Applicant's Signature Date (mm-dd-yyyy) Print Name Title *Applicants sh ould be aware t hat all information submitted in or accompanying an application may be subject to the provisions of theMaryland Public Information Act (Md.)

7 Code, State Government Article, Title 10, Subtitle 6, Part III) and to the provisions of Md. Code, Tax General Article, 10-733(i). Page 3 of 4 Page 4 of 4 Instructions GENERAL INFORMATION In order to apply for a CYBERSECURITY INVESTMENT INCENTIVE Tax Credit, should complete the appropriate Qualified Investor Form (Form , , or ). companies should complete Form B to qualify as a Qualified MARYLAND CYBERSECURITY Company ( QMCC ).3. Send all completed forms and requested documents to the MARYLAND Department of Commerce ( Commerce ) at: CYBERSECURITY INVESTMENT INCENTIVE Tax Credit MARYLAND Department of Commerce ATTN: Tax Incentives Group 401 East Pratt Street 17th Floor Baltimore, MD 21202 QMCC PRE-QUALIFICATION Beginning on May 15, 2019, Commerce will accept Form B applications from CYBERSECURITY companies to be pre-qualified as QMCCs.

8 Pre-qualification applications will be accepted through May 22, 2019. Commerce will review pre-qualification requests as soon as completed Form B applications have been received and will send pre-qualification notifications out no later than June 10, 2019. INVESTOR APPLICATION PROCESS The investor application procedure is a two-step process. Please note that an investor must apply for a CYBERSECURITY INVESTMENT INCENTIVE Tax Credit before they make an INVESTMENT in a QMCC. Step 1: Beginning June 3, 2019, completed Investor application Forms , or , with all attachments, will be accepted at Commerce s offices: Tax Incentives Group, CYBERSECURITY INVESTMENT INCENTIVE Tax Credit, 401 East Pratt Street, 17th Floor, Baltimore, MD 21202, or via the CYBERSECURITY INCENTIVE INVESTMENT Tax Credit Online Portal.

9 Completed Form B applications are also required if it was not filed for pre-qualification. For completed investor applications received before June 24, 2019, Commerce will issue an investor a User Name and Reference Number within 72 hours after receipt of the completed investor application. For completed investor applications received after June 24, 2019, Commerce will issue an investor a User Name and Reference Number after July 1, 2019. Step 2: The second step of the application process requires the investor, using the investor s User Name and Reference Number, to finalize their application electronically. Electronic submissions will begin at 9:00 EDT on July 1, 2019, through the website ( ).

10 Awards of tax credits are determined on a first come, first served basis, based solely on Commerce s receipt of an investor s electronic submission of their User Name and Reference Number. No physical submissions will be accepted for this second step. Multiple submissions by an applicant using the same User Name and Reference Number will be considered filed at the date and time of the LAST submission. Any decision made by Commerce during the application process is considered final. Investor applications are reviewed and approved in the order received. After receiving a fully completed application, Commerce will either issue an initial tax credit certificate certifying the amount of an approved tax credit to a Qualified Investor or reject the application.