• ILLINOIS ANGEL INVESTMENT TAX CREDIT PROGRAM

    Investor Claimant Application 2022

  • CLAIMANT INFORMATION


  • CONTACT INFORMATION

    Contact Info for All Correspondence (if different than claimant listed above)
  • Please update contact information if you would like correspondence to be provided to another contact.

  • INVESTMENT INFORMATION

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  • Please note: SAFEs and Convertible Notes can be approved as long a they include a mandatory clause and meet all other eligibility criteria.

     

  • "Angel Investment" means money (or its equivalent) given to a qualified new business venture, at a risk of loss, in consideration for an equity interest of the qualified new business venture. For the purpose of this definition, an investment is at a risk of loss if its repayment depends entirely upon the success of the business operation of the Qualified New Business Venture. 

  • REQUIRED ATTACHMENTS

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  • Please complete the "Trust identification and Disclosure Form" found here. 

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  • CERTIFICATION

  • Authorized Executive Officer/Individual:

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  • NOTE: You can print your responses for your own records, but you must select "Preview Answers" below and then "Submit" to complete the submission process. You will see a confirmation page appear and receive a confirmation email. 

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  • Please download the Certification Form from here, then attach the signed form using the button below. 

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  • The Department of Commerce and Economic Opportunity (DCEO) is committed to protecting the privacy of its vendors, grantees and beneficiaries of programs and services. At times, DCEO will request social security numbers (SSNs) or other personal identifying information. Federal and state laws, rules and regulations require the collection of this information for certain purposes relating to employment and/or payments for goods and services, including, but not limited to, grants. DCEO also collects confidential information for oversight and monitoring purposes.

    Furnishing personal identity information, such as a social security number, is voluntary; however, failure to provide required personal identity information may prevent an individual or organization from using the services/benefits provided by DCEO as a result of state or federal laws, rules and regulations.

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