Great Falls Development Authority, Inc. (CDC)

and

High Plains Financial, Inc. (CDC)

Loan Application Submittal Checklist

In completing the application forms, GFDA and HPF urge the applicant to submit the same information previously submitted to a bank, local development corporation, or federal/state-lending agency. In most cases, the same documentation may be used.

A $500.00 application fee payable to High Plains Financial, Inc. or Great Falls Development Authority must accompany this application for preparation of the loan package and any out-of-pocket costs incurred by the CDC in processing the loan request. Out-of-pocket costs may include credit reports, flood certifications, underwriting services, among others. If the loan is declined, CDC will refund the entire deposit less out-of-pocket costs to date. If the loan is approved, CDC will apply the deposit amount to the origination costs of the loan.

  1. Loan Application [use full legal name(s)]
  2. Completed Sources and Uses Statement - attached
  3. Complete Business Plan that includes financial projections for 3 years (and if an existing business 3 years of historical financial information)
  4. Interim Financial statements (not over 60 days old) including List of Debts outstanding for the business that shows creditor, terms, and balance outstanding (for existing businesses only)
  5. Debt Schedule - attached
  6. Aging of accounts receivable and accounts payable not over 60 days old (for existing businesses only)
  7. Federal Tax Returns for the business (signed) for the past three years. If purchasing an existing business, please provide theirs.
  8. If purchasing an existing business, a copy of the sales agreement.
  9. If your business is a franchise or you are purchasing a franchise, include a copy of the franchise agreement and the Franchisor’s FTC Disclosure Statement
  10. If purchasing real estate, an independent appraisal on the property being acquired that includes: before construction value, after construction value, and quick sale value and copy of the buy/sell agreement.
  11. Environmental Risk Questionnaire - attached
  12. A copy of existing or proposed lease agreement
  13. Letter of Commitment of Funds or Letter of Denial of Credit from all banks and lenders participating in the project
  14. If new construction: preliminary plans and specifications covering new construction and cost estimates. Final plans will be required before disbursement.
  15. Resumes/Personal History Statement of all the principals involved in the project – SBA Form 912 attached
  16. Current personal financial statement for each individual or, if a business, each owner, partner and stockholder with 20% or more ownership of the business – SBA Form 413 attached
  17. The past three years personal tax returns of each owner/partner/stockholder with 20% or more ownership of the business (signed)
  18. If a Corporation, provide a Resolution from the Board of Directors authorizing the business to borrow. If a Partnership is involved, provide a Certificate as to Partners
  19. Copy of business’ corporate papers [i.e.: Articles of Incorporation, Bylaws (include minutes regarding any changes to Bylaws), Articles of Organization, Operating Agreement, Partnership Agreement]
  20. If any officer, director, or controlling group of the Great Falls Development Authority, Inc. is an officer, director, or holder of any direct or indirect pecuniary interest in the business please attach an explanation
  21. If this application is for an existing business, copy of insurance binder.

*** Please note, if you are using machinery, equipment and other assets as collateral, we will need a complete description list with all serial numbers, model numbers and value (over $500) prior to closing.

If using titled vehicles as collateral, we will need the titles prior to closing.

If using a liquor license or brand filing, we will need the filing information prior to closing.***

If this is an EPA Revolving Loan Fund application, we will require numbers 1-4, 6, 7, 9-23 in addition to the following:

_____ Proof of 20% match requirement

_____ Site cleanup plan sent for approval to Montana Department of Environmental Quality

_____ Proof of site control (copy of the buy/sell agreement, deed of trust, mortgage, etc.)

_____ Satisfaction/explanation of any pending lawsuits regarding the site

EQUAL CREDIT OPPORTUNITY ACT

The Federal Equal Opportunity Act prohibits creditors from discrimination against applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant’s income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The Federal agency that administrates compliance with this law concerning this creditor is: USDA Director of the Office of Civil Rights, Whitten Building, Room 326-W, 14th and Independence Avenue SW, Washington DC 20250-9410.


IMPORTANT INFORMATION ABOUT IDENTIFICATION PROCEDURES

WHEN OBTAINING A LOAN WITH THIS CDC COMPANY

To help the government fight the funding of terrorism and money laundering activities, Federal law (US Patriots Act) requires all Certified Development Companies to obtain, verify and record information that identifies each person who applies for a loan.

What that means to you: When you apply for a loan, we will ask for your name, address, date of birth, and other pertinent information which will allow us to identify you. We may also ask for a copy of your driver’s license or other identifying documents.

EQUAL CREDIT OPPORTUNITY ACT

The Federal Equal Opportunity Act prohibits creditors from discrimination against applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant’s income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The Federal agency that administrates compliance with this law concerning this creditor is: USDA Director of the Office of Civil Rights, Whitten Building, Room 326-W, 14th and Independence Avenue SW, Washington DC 20250-9410.


Great Falls Development Authority, Inc. and

High Plains Financial, Inc. Loan Application

How did you hear about us? ______

Loan Program Desired (circle 1):

SBA 504 USDA IRP EDA RLF EPA RLF CRF

Only businesses located in Cascade, Glacier, Pondera, Teton and Toole are eligible for EDA RLF and IRP assistance and loans will be recalled if the project activity is moved from these areas. The IRP is also available in Fergus and Judith Basin counties. The EPA RLF is available only in Cascade County. The Community Reinvestment Fund is available state-wide. Businesses relocating jobs from another community area are not eligible borrowers.

If you presently have an active bankruptcy, you do not qualify for a loan under our programs’ guidelines. If you have successfully completed your bankruptcy plan, please provide your discharge papers. Thank you.

1.  Borrower’s name, address and contact’s title in company

Company name: ______

Contact Person: ______Title: ______

Address: ______

Telephone: ______Fax: ______

Website/e-mail: ______

Cell #: ______Tax ID # or SS # ______

2.  Project address (if different from above):

Address ______

______

3.  Type of business: ______Number of Years in operation ______

Product or services provided: ______

Is your business seasonal? ____ Yes ____ No Seasonal Influences: ______

______

Business location: ___ Home ___ Storefront ___ Market ___ Street ___ Other ______

SIC Code: ______NAICS Code: ______

4. Is this company a:

5. Affiliates: List all business concerns in which the applicant company or any of the individuals listed in the Ownership Section below have an ownership interest of 20% or more.

Company Name Owner % of Ownership

______

______

______

______

______

6.  Names, addresses, titles and percentage of ownership of all owners, officers, directors and shareholders (who own 10% or more shares) of the company. (Supply attachments if needed.) Attach resumes of all owners and officers.

Name / Title / Address / % Owned

7.  Do you have co-signers and/or guarantors for this loan? ____ Yes ____ No. If yes, please provide

Name: ______SS#: ______

Address: ______

Please provide personal financial sheet for each guarantor. If additional, please use separate sheet.

8.  Are you applying for a:

9.  Which financial institution are you working with (name of loan officer and telephone number): ______

10.  Reason funds are needed: ______

The purpose of GFDA and HPF is to support business activities for which credit is not otherwise available on terms and conditions which would permit completion and/or the successful operation of accomplishment of the project in the following eligible areas (Cascade, Glacier, Pondera, Teton and Toole Counties). The lender reserves the right to recall the loan if these requirements are not met.

11.  Total project costs: ______

12.  Anticipated sources and uses: Please use separate Sources and Uses form.

13. What collateral will be used to secure this loan?

Item: Value Own free & clear?

______

______

______

______

______

14.  Estimated number of permanent jobs created or retained as a result of the project or activity

No. of current employees: ______No. of new jobs to be created: ______

No. of existing jobs retained/saved: ______

Salary range to be offered (per hour): ______

Current No. of female employees:____ No. of minority employees (best guess):_____

15.  List below the names of any past or present City of Great Falls/Cascade County employees, GFDA or HPF Loan Administration Board members who are related by blood, marriage, adoption, or who have any present or past financial interest or association with applicant, or any of the applicants partners, officers, directors, stockholders, or business:

Name and Address / Details of Relationship or Interest

16.  Are you or your business involved in any appending lawsuits? ____ Yes ____ No. If yes, please provide details. ______

______

______

17.  EPA Revolving Loan Fund applicants only: Are there any pending lawsuits regarding the site? ____Yes ___ No. If yes, please describe: ______

______

How will the lawsuit be satisfied? ______

______You may use a separate sheet if necessary.

18. EPA RLF applicants only: Have you submitted a voluntary cleanup plan to the Montana Department of Environmental Quality? _____ Yes _____No. If yes, please provide a copy of the plan. If no, please attach a narrative describing the proposed cleanup project and the estimated date that a clean up plan will be submitted to DEQ.

19.  EPA RLF applicants only: How will 20% matching requirement be met? ______

______.


INFORMATION RELEASE

I/we certify that employees and applicants for employment of our company are not discriminated against on the basis of race, color, national origin, religion, age, handicap, or sex; and furthermore, I/we realize that this document is just an application for a loan. A loan request shall not be considered approved until formal approval is made by the Loan Review Committee. I/we authorize Great Falls Development, Inc./High Plains Financial, Inc. to contact my credit references and to view my credit report as authorized by law. I authorize Great Falls Development Authority, Inc./High Plains Financial, Inc. to contact the bank listed on this application about the project. I certify and affirm by my signature that the information contained in, and otherwise supplied as part of this application, is complete, true and current to the best of my knowledge. I further understand that intentional misrepresentation of facts may be the basis for a denial of credit. I understand that Great Falls Development Authority, Inc./High Plains Financial, Inc. will retain this application whether the loan is approved or denied and that I can appeal their decision if the loan is denied.

______

Signature Signature

______

Title Title

______

Date Date

EQUAL CREDIT OPPORTUNITY ACT

The Federal Equal Opportunity Act prohibits creditors from discrimination against applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant’s income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The Federal agency that administrates compliance with this law concerning this creditor is: USDA Director of the Office of Civil Rights, Whitten Building, Room 326-W, 14th and Independence Avenue SW, Washington DC 20250-9410.


Great Falls Development Authority, Inc.

and

High Plains Financial, Inc.

Additional Information Form

The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the racial/national origin of the individual applicants on the basis of visual observation or surname.

Ethnicity:

Race (Mark one or more):

Gender:

This is an Equal Opportunity Program. Discrimination is prohibited by Federal Law. Complaints of discrimination may be filed with USDA, Director, Office of Civil Rights, Room 326-W, Whitten Bldg., 1400 Independence Ave, SW, Washington, DC 20250-9410.

______

Company Name

______

Name

______

Date