1. Name of Applicant(s):__________________________________________________
2. Mailing Address of Applicant: ____________________________________________
3. Telephone Number: __________________________
4. Proposed Business Address: ______________________________, Mason, Michigan
5. Does the applicant own the building? ________ Yes _______ No
(If the answer to No. 5 is No, please attach a letter from the building owner evidencing a commitment to the applicant)
6. Estimated Total Project Cost: $_______________
7. Total Private Loan being obtained: $_______________
8. Total Loan Guarantee Request (not to exceed $25,000): $___________
9. Proposed project start date: ___________________________
10. Proposed opening date: _____________________________
11. The legal name of the borrower will be: ญญญญญญญญญญญญญญญญญญญ____________________________
12. The borrower is (circle one): Individual Corporation LLC Partnership Other
13. The following are attached to this application:
_____ A narrative description of the proposed business
_____ A business plan
_____ Copies of applications for other financing and all supporting documents
_____ Financial statements for last two tax years for a business expanding or relocating
_____ Financial statements and tax returns for borrower and any proposed guarantors for last two years
_____ Authorization to verify financial information and obtain credit reports signed by borrower and each guarantor
_____ Loan Commitment from private lender
The undersigned applicant affirms that:
1. The information in this application is true and accurate.
2. The applicant has read and understands the conditions of the Mason DDA Business Attraction Loan Guarantee Program which are incorporated by reference.
3. The Mason DDA has reserved the right in its sole discretion to reject this application..
Date: _________________________
Signature of Applicant(s):
______________________________ ____________________________
Tax ID# of business: __________________________
When completed submit to: Phil Birdsall, Mason DDA Executive Director, 201 W. Ash, Mason, MI 48854