APPLICATION FOR OFFICIAL INTENT
The purpose of this application is to provide a brief description of the proposed project and financing in order to assist the Business Finance Authority (the "BFA") in determining whether the project appears eligible for financing through an issue of bonds by the BFA and, if so, whether it should be so financed.
Please answer all questions or insert N/A where questions do not apply, and submit this application along with each of the following items, if applicable. We ask that you provide twenty (20) copies of any bound or printed materials.
For all projects:
a. the applicant's annual report, brochure or other printed material describing the applicant;
b. the applicant's most recent available annual financial statements, or other financial
information about the applicant; and
c. the BFA does not charge nonprofits an application fee.
Applications should be submitted to:
Business Finance Authority
2 Pillsbury Street, Suite 201
Concord, New Hampshire 03301-4954
Attn: Executive Director
If you have any questions about this application or the BFA's bond program, please call the BFA's offices at (603) 415-0190. If you need more space for any question, please attach additional sheets.
Name of Applicant
Address
City/Town State Zip
Contact Title Phone
Name and address of owner of project (if different)
Names and addresses of lessees of project (if any)
Amount of bond issue $
Address of project site:
Briefly describe the project:
Estimated
Cost Size
Land Acquisition $ _______________ ____________ acres
Building Acquisition $ _______________ ____________ sq. ft.
Building Construction $ _______________ ____________ sq. ft.
Building Renovation $ _______________ ____________ sq. ft.
Equipment Acquisition $_______________ ____________
Cost of Bond Issuance $ _______________
Refinance Existing Debt $_______________
Other (describe)
Describe the effect of the project on the environment
When do you expect the project to begin?
When do you expect the project to be completed?
How many jobs will be created or preserved by the project?
Created Preserved
Describe the types of jobs created or preserved, their wage and salary levels and, if applicable, when the jobs will be created:
Names and addresses of contractors and subcontractors for the project:
Describe the Applicant (and if applicable the owner and the lessees). Include a brief history of the Applicant, its principal products, and its customers:
Briefly describe the background of the Applicant's (and if applicable the owner's and lessees') key management personnel:
Is the Applicant an equal opportunity employer? , the owner? , the lessee?
Please provide any other information of which you believe the BFA should be aware in considering this application:
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The Applicant will promptly advise the BFA of any change in the foregoing information, or of any additional information that may become available as plans for the project progress.
Date: ____________________
__________________________
Authorized Officer of Applicant