Finance : Capital Financing Application

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Capital Financing Application

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a Submitter Information
1 Submitter Name: (Last, First)
2 E-Mail Address:
3 Relationship to Applicant: (Type 'myself' if Applicant is you)

 

I Application Information
1 Applicant Official Name:
2 Type of Organization: (Township, School District, Fire District, Local Authority, Qualified 501(c) 3 "Not-for-Profit" Entity)
3 Contact Person:
4 Address: (Street, City, State, Zip)
5 Phone Number:
6 Fax Number:
7 Officer(s), Director(s), Partner(s) of applicant as applicable:

 

II Project Description
1 Please provide a brief narrative description and current status of the project for which the financing is being sought:

 

III Project Information
1 Description of real estate acquisitions or improvements to be financed (ie, land acquisitions, building improvements, etc.) if applicable:
2 Estimated hard or capital cost of land and/or improvements (ie, without engineering architecture, legal, and other professional expenses):
3 Estimated soft costs associated with acquisitions and/or improvements (ie, without engineering, architecture, legal, other professional expenses):
4 Location of acquisition or facilities to be improved:
5 Does applicant currently own land and/or facilities to be improved?

Yes

No
6 Owner of land and/or facilities if not applicant:
7 Does applicant currently lease land and/or facilities to be improved?

Yes

No
8 Current principal use of land or facilities to be improved:
9 Description of capital equipment (please provide cost for each item of equipment):
10 Estimate hard cost of capital equipment (please provide cost for each item of equipment):
11 Estimated soft costs associated with capital equipment (if any):

 

IV Project Timetable
1 Please describe the desired term of the financing (ie, length of repayment period) for each improvement and/or capital equipment:
2 Please provide the desired timetable for completion of the financing:
3 Please provide any key milestone dates and/or events relating to the project:

 

V Project Consultants
1 Please provide the name, address and phone number of any professionals working on the project on behalf of the applicant as applicable:
a Engineers:
b Architects:
c Contractors:
d Attorneys:
e Auditors/Accountants:
f Other Consultants:

 

VI Other Indebtedness
1 Please provide a detailed description of any other indebtedness of the applicant including bonds, leases, loans, etc., including amounts, terms of repayment, terms of optional redemption of early retirement, if any:

 

VII Expenditures
1 Have any expenditures been made to date or are any expenditures expected to be made toward the project prior to the completion of the financing (if so, please describe how much, on what dates, and for what purposes):
2 Does the applicant expect to reimburse itself for any or all of these prior expenditures?
3 Has the applicant adopted any declaration of intent to reimburse itself for any expenditure with the proceeds of a tax-exempt financing? (If so, please provide details):

 

VIII Project Benefits
1 Please describe how the project will maintain or provide new employment for the people of Mercer County, maintain or increase the tax base of Mercer County and/or maintain, diversify and expand business and industry in Mercer County: