Address: _ City: State: Zip: _ B. Do the Owners of the Company have an Ownership interest in any Other Company? Yes No If Yes to Either A or B Identify Below: Company Name Relationship % Owned _ _ Identify All Entities Participating with the Financing of the Project. Participation Identification: A. _ Financial Institution(s) (City) (State) (Zip) Name: Telephone: ( ) Address: Title: Email address: _ (City) (Zip) Name: Contact Person: _ Address: Title: Email address: _ (City) (State) (Zip) Telephone: ( ) Telephone: ( ) B. Email address: Other Local, State or Federal Financing Sources Agency Name: Name: Address: Address: (City) (State) (Zip) Contact Person: Title: Email address: (City) (State) (Zip) Telephone: ( ) Contact Person: Title: Email address: C. Source(s) of Equity/Investment Capital Telephone: ( ) Name: Address: Agency Name:
Address: _ City: State: Zip: _ B. Do the Owners of the Company have an Ownership interest in any Other Company? Yes No If Yes to Either A or B Identify Below: Company Name Relationship % Owned _ _ Participation Identification: Identify All Entities Participating with the Financing of the Project. A. Financial Institution(s) Name: Address: _ (City) (Zip) Contact Person: _ Title: Email address: Telephone: ( ) B. Other Local, State or Federal Financing Sources Agency Name: Address: (City) (State) (Zip) Contact Person: Title: Email address: Telephone: ( ) C. Source(s) of Equity/Investment Capital Name: Address: _ (City) (State) (Zip) Telephone: ( ) Title: Email address: Name: Address: _ (City) (State) (Zip) Telephone: ( ) Email address: Name: Address: (City) (State) (Zip) Contact Person: Title: Email address: Telephone: ( ) Agency Name:
Chapter9-EconomicDevelopment.docx