BOND FINANCING APPLICATION

General Information

GCIDA Bond Financing Application

"*" indicates required fields

Name*

First Last

Phone*

Email*

Company*

Title*

Legal name and information of the organization

Legal name of the organization*

Legal Address of the organization*

Street Address Address Line 2 City State ZIP Code

Organization Phone*

Organization Email*

TIN/EIN of the organization*

Detailed description of the entity requesting funding

Description of the product manufactured by the entity requesting funding

Ownership structure of the entity

State of incorporation

State

Year of incorporation

Name of project to be funded; location of the project (including any county or city official contacts who are working on the project with entity)

Detailed description of the project, including its intended purpose, use, or function

Estimated number of new jobs to be created by the Project

Proposed budget for the project and use of bond proceeds, including any of the following: land acquisition; building acquisition; construction or remodel; equipment costs; cost of issuance; capitalized interest; reserves.

Provide due dates or other deadlines that GCA needs to be aware of surrounding your project.

Amount requested for bond financing; proposed close date.

Type of offering (public or private – if public, please provide expected rating under Moody’s, S&P, and/or Fitch); information on any credit enhancements or letters of credit; and other sources of funding, if any.

Name, address, and phone number of entity’s General Legal Counsel

General Legal Counsel Name

First Last

General Legal Counsel Phone

General Legal Counsel Email

General Legal Counsel Address

Street Address Address Line 2 City State ZIP Code

Name, address, and phone number of entity’s Financial Advisor

Financial Advisor Name

First Last

Financial Advisor Phone

Financial Advisor Email

Financial Advisor Address

Street Address Address Line 2 City State ZIP Code

Name, address, and phone number of entity’s Bond Counsel

Bond Counsel Name

First Last

Bond Counsel Phone

Bond Counsel Email

Bond Counsel Address

Street Address Address Line 2 City State ZIP Code

Name, address, and phone number of entity’s Underwriter

Underwriter Name

First Last

Underwriter Phone

Underwriter Email

Underwriter Address

Street Address Address Line 2 City State ZIP Code

Name, address, and phone number of entity’s Bank/Bond Purchaser, as appropriate

Bank/Bond Purchaser Name

First Last

Bank/Bond Purchaser Phone

Bank/Bond Purchaser Email

Bank/Bond Purchaser Address

Street Address Address Line 2 City State ZIP Code

Additional Information

Phone

This field is for validation purposes and should be left unchanged.

BOND FINANCING APPLICATION

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General Information

GCIDA Bond Financing Application

Legal name and information of the organization

Name, address, and phone number of entity’s General Legal Counsel

Name, address, and phone number of entity’s Financial Advisor

Name, address, and phone number of entity’s Bond Counsel

Name, address, and phone number of entity’s Underwriter

Name, address, and phone number of entity’s Bank/Bond Purchaser, as appropriate

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