|
Your Name – enter your name or nickname as you want it displayed |
|
|
Name of Business |
|
|
Primary area of practice |
please specify field of law here:
|
|
2nd area of practice: (optional) |
please specify field of law here:
|
|
3rd area of practice: |
please specify field of law here:
|
|
4th area of practice: |
please specify field of law here:
|
|
5th area of practice: |
please specify field of law here:
|
|
Location – where you practice law (fill in as many fields as you
would like) |
|
|
|
Note: your profile does not go live until
you contribute a form
|
|
Click image below to see how we display your
profile
|
- Receive a free profile listing your firm's areas of expertise
- All contributed forms prominently display your business profile,
which include the optional fields of your phone number, email, and website address(see
example in top right)
- Connect with thousands of businesses, professionals, and potential
customers looking to use your expertise and services
- Your form will be highly optimized for the search engines, enabling people doing
keyword searches related to your business to find you via the profile we display
about you
- Feel good by giving back to the community by providing quality legal and business
forms for free
- You're protected: all users who download your forms agree to idemnify you Learn More
|
|
|
Your Name – enter your name or nickname as you want it displayed |
|
|
Name of Business |
|
|
2nd area of practice: (optional) |
please specify field of law here:
|
|
3rd area of practice: |
please specify field of law here:
|
|
4th area of practice: |
please specify field of law here:
|
|
5th area of practice: |
please specify field of law here:
|
|
Location – where you practice law (fill in as many fields as you
would like) |
|
|
|
Note: your profile does not go live until
you contribute a form
|
|
Click image below to see how we display your
profile
|
- Receive a free profile listing your firm's areas of expertise
- All contributed forms prominently display your business profile,
which include the optional fields of your phone number, email, and website address(see
example in top right)
- Connect with thousands of businesses, professionals, and potential
customers looking to use your expertise and services
- Your form will be highly optimized for the search engines, enabling people doing
keyword searches related to your business to find you via the profile we display
about you
- Feel good by giving back to the community by providing quality legal and business
forms for free
- You're protected: all users who download your forms agree to idemnify you Learn More
|
|
|
Your Name – enter your name or nickname as you want it displayed |
|
|
Name of Business |
|
|
2nd area of practice: (optional) |
please specify field of law here:
|
|
3rd area of practice: |
please specify field of law here:
|
|
4th area of practice: |
please specify field of law here:
|
|
5th area of practice: |
please specify field of law here:
|
|
Location – where you practice law (fill in as many fields as you
would like) |
|
|
|
Note: your profile does not go live until
you contribute a form
|
|
Click image below to see how we display your
profile
|
- Receive a free profile listing your firm's areas of expertise
- All contributed forms prominently display your business profile,
which include the optional fields of your phone number, email, and website address(see
example in top right)
- Connect with thousands of businesses, professionals, and potential
customers looking to use your expertise and services
- Your form will be highly optimized for the search engines, enabling people doing
keyword searches related to your business to find you via the profile we display
about you
- Feel good by giving back to the community by providing quality legal and business
forms for free
- You're protected: all users who download your forms agree to idemnify you Learn More
|
|
|
Our Spam Policy
We hate getting spam as much as you do. So we have implemented a tough spam policy
regading how we deal with your email. We pledge that we will:
- Never rent, trade, or sell any email or any personal information to any third
party without your explicit consent
Terms Of Use
Submissions to this site, including any legal or business forms, posts, responses
to questions or other communications by contributors are not intended as and should
not be construed as legal advice. You are strongly encouraged to consult competent
legal council before engaging in any action based upon content contained on this
site.
These downloadable forms are only for personal use. Retransmission, redistribution,
or any other commercial use is prohibited. This includes reposting forms from this
site to another site offering free legal or other document forms for download.
Please note that the donator may have included different usage terms regarding this
form, and you agree to abide by these terms. It is highly recommended that you have
a licensed attorney review any legal documents for which you are searching in order
to make sure that your needs are being properly and completely satisfied.
Your use of this site constitutes your acceptance of our terms of use and your agreement
to hold this site, its officers, employees and any contributors to this site harmless
for any damage you might incur from your use of any submissions contained on this
site. If you do not agree to the above terms, please do not proceed.
These forms are provided to assist business owners and others in understanding important
points to consider in different transactions. They are offered with the understanding
that no legal advice, accounting, or other professional service is being offered
by these documents or on this website. Laws vary in the different states. Agreements
acceptable in one state may not be enforced the same way under the laws of another
state. Also, agreements should relate specifically to the particular facts of each
situation. Therefore, it is important to consult legal counsel whenever utilizing
these forms. The Forms are not a substitute for legal advice YourFreeLegalForms.com
is not engaged in recommending or referring members on the site or making claims
about the competence, character or qualifications of its participating members.
Close
Thank you for using
Yourfreelegalforms.com
Your online source for 100% free legal and business forms.
Have a form to contribute?
Contribute a legal or business form, checklist or article and have your profile
displayed on the same page as the form for free, powerfull, targeted marketing to
those searching for legal forms and advice.
Rate this form
(must be logged in)
|
|
Social Bookmark this Form
|
|
|
Advertise your business to thousands for free –
Contribute a form
|
|
Form #1400WEST VIRGINIA ECONOMIC DEVELOPMENT AUTHORITY APPLICATION FOR FINANCIAL ASSISTANCE
|
Average user rating: |
Not Yet Rated
|
Rate it |
|
WEST VIRGINIA ECONOMIC DEVELOPMENT AUTHORITY APPLICATION FOR FINANCIAL ASSISTANCE
|
Need this form customized? |
Download This Form
|
Printer Friendly Version
Terms Of Use
Submissions to this site, including any legal or business forms, posts, responses
to questions or other communications by contributors are not intended as and should
not be construed as legal advice. You are strongly encouraged to consult competent
legal council before engaging in any action based upon content contained on this
site.
These downloadable forms are only for personal use. Retransmission, redistribution,
or any other commercial use is prohibited. This includes reposting forms from this
site to another site offering free legal or other document forms for download.
Please note that the donator may have included different usage terms regarding this
form, and you agree to abide by these terms. It is highly recommended that you have
a licensed attorney review any legal documents for which you are searching in order
to make sure that your needs are being properly and completely satisfied.
Your use of this site constitutes your acceptance of our terms of use and your
agreement to hold this site, its officers, employees and any contributors to this
site harmless for any damage you might incur from your use of any submissions contained
on this site. If you do not agree to the above terms, please do not proceed.
These forms are provided to assist business owners and others in understanding important
points to consider in different transactions. They are offered with the understanding
that no legal advice, accounting, or other professional service is being offered
by these documents or on this website. Laws vary in the different states. Agreements
acceptable in one state may not be enforced the same way under the laws of another
state. Also, agreements should relate specifically to the particular facts of each
situation. Therefore, it is important to consult legal counsel whenever utilizing
these forms. The Forms are not a substitute for legal advice. YourFreeLegalForms.com
is not engaged in recommending or referring members on the site or making claims
about the competence, character or qualifications of its participating members.
|
West Virginia.
WEST
VIRGINIA ECONOMIC DEVELOPMENT AUTHORITY APPLICATION FOR FINANCIAL ASSISTANCE
Date
_________
A. Borrower:
Name .............................................................................................................................................................................................
Address .........................................................................................................................................................................................
County _________ Telephone _________ Contact Person
_________
Address of Principal Corporate Offices, if different
from above:
_______________ _______________
Authorized Representative of Applicant:
Name .............................................................................................................................................................................................
Title _________ Telephone _________
B. Local Development Authority (all
applications must be sponsored by a LDA):
Name .............................................................................................................................................................................................
Address .........................................................................................................................................................................................
Telephone _________ Contact Person _________
C. Type of Financing Being Requested:
_______________ WVEDA Direct Loan
_______________ SBA 504
D. Applicant is (or will be if not yet
in existence):
1).
|
_________ Corporation
|
_________ Joint Venture
|
|
_________ Limited Partnership
|
_________ Sole Proprietor
|
|
_________ General Partnership
|
_________ Individual
|
2). Incorporated in or formed in the state of:
_______________
E. Applicant's Federal Tax I.D. Number:
........................................................................................................................................
Worker's Compensation Number: ...........................................................................................................................................
F. Applicant's Legal Counsel:
Name .............................................................................................................................................................................................
Firm ...............................................................................................................................................................................................
Address .........................................................................................................................................................................................
G. Primary Bank Relationship:
Bank Name ...................................................................................................................................................................................
Contact Person ............................................................................................................................................................................
Address .........................................................................................................................................................................................
Telephone .....................................................................................................................................................................................
H.
|
Estimated Uses of Funds:
|
Estimated
|
|
(complete as applicable)
|
Cost
|
|
1. Acquisition of land, excluding existing
improvements
|
$.......................................................................................................
|
|
2. Acquisition of building or other improvements
|
......................................................................................................... Â
|
|
3. Site preparation, utilities roads, etc.
|
......................................................................................................... Â
|
|
4. Construction
|
......................................................................................................... Â
|
|
5. Renovation
|
......................................................................................................... Â
|
|
6. Machinery and/or equipment
|
......................................................................................................... Â
|
|
TOTAL ELIGIBLE COSTS
|
$.......................................................................................................
|
I.
|
Other Estimated "Soft" Costs:
|
|
|
(complete as applicable)
|
|
|
1. Bonds and insurance
|
$.......................................................................................................
|
|
2. Interest during construction
|
......................................................................................................... Â
|
|
3. Architectural and engineering fees
|
......................................................................................................... Â
|
|
4. Legal fees
|
......................................................................................................... Â
|
|
5. Accounting fees
|
......................................................................................................... Â
|
|
6. Commitment fee or points
|
......................................................................................................... Â
|
|
7. Appraisals
|
......................................................................................................... Â
|
|
8. Miscellaneous
|
......................................................................................................... Â
|
|
TOTAL OTHERS COSTS
|
$.......................................................................................................
|
J. Subsidiaries or Affiliates of
Applicant:
Name .............................................................................................................................................................................................
Address .........................................................................................................................................................................................
Name .............................................................................................................................................................................................
Address .........................................................................................................................................................................................
K. List all other locations in West
Virginia where the Applicant operates:
_______________
_______________
L. Type of Project:
_________ New business with creation of new jobs
_________ Expansion of existing business with creation
of new jobs
Modernization and retention of existing business with
intention of
_________ preserving jobs
_________ Other: .........................................................................................................................................................................
M. Breakdown of Total Project Financing:
|
Â
|
Dollar
|
|
Sources of Debt:
|
Amount
|
|
WVEDA
|
$..................................................................................
|
|
............................................................................................................................... Â
|
.................................................................................... Â
|
|
............................................................................................................................... Â
|
.................................................................................... Â
|
|
............................................................................................................................... Â
|
.................................................................................... Â
|
|
TOTAL
|
$..................................................................................
|
|
Sources of Equity:
|
|
|
Applicant
|
.................................................................................... Â
|
|
............................................................................................................................... Â
|
.................................................................................... Â
|
|
............................................................................................................................... Â
|
.................................................................................... Â
|
|
TOTAL
|
$..................................................................................
|
|
Other Sources of Financing:
|
|
|
Applicant
|
.................................................................................... Â
|
|
............................................................................................................................... Â
|
.................................................................................... Â
|
|
TOTAL
|
$..................................................................................
|
|
GRAND TOTAL
|
$_____ (Should agree with total eligible costs from
Part H.)
|
N. Financing:
|
Â
|
Company Equity
|
Financial Institution Participation
|
Other
|
WVEDA Request
|
|
Name ......................................................................................................................................................................................................... Â
|
|
Amount ..................................................................................................................................................................................................... Â
|
|
Rate ........................................................................................................................................................................................................... Â
|
|
Term .......................................................................................................................................................................................................... Â
|
|
Collateral ................................................................................................................................................................................................. Â
|
|
Value ......................................................................................................................................................................................................... Â
|
O. Commitments: Please attach
copies of commitments (including commitments for interim financing, if
applicable) for the Projects which have already been obtained from private
sector lenders or investors. Please include contact name, address and telephone
number. If no commitment has been attached, please explain.
_______________
_______________
_______________
P. Impact on the Community:
|
Fiscal Year Date:
|
Current
|
After 1 Yr.
|
After 2 Yrs.
|
After 3 Yrs.
|
|
Annual Sales
|
|
Annual Payroll
|
|
Number of Employees
|
|
Salary/Wage Range
|
SUPPORTING SCHEDULES OFFICERS, STOCKHOLDERS & KEY
PERSONNEL
Include management, officers and stockholders owning
10% or more of company's stock. Publicly held companies may substitute copy of
annual report or 10K.
|
Name
|
Title or Position
|
Yrs. Emplyd.
|
Age
|
Education
|
Annual Salary
|
Other Comp.
|
% Ownership
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
PRINCIPAL
CUSTOMERS
|
Name
|
City, State
|
Products
|
Annual Purchases ($)
|
Percent of Total Sales
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
PRINCIPAL
SUPPLIERS
|
Name
|
Address
|
Products Purchased
|
Annual Amt. Purchased
|
% of Totals Purchases
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
PRINCIPAL
COMPETITORS
|
Name
|
City/State
|
Product Lines
|
Estimated Annual Sales
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
|
.................................................................................................................................................................................................................... Â
|
Signature
of Authorized Company
Representative Verifying
Accuracy
of Information:
_______________
Signature
_______________
Date
SPONSOR/LOCAL DEVELOPMENT
AUTHORITY
_______________
Signature
_______________
Date
PLEASE PROVIDE THE FOLLOWING ATTACHMENTS:
1. Description of Project: Attach a narrative
description of the project including size, type of construction, equipment to
be purchased, etc.
2. History of Company: Attach a comprehensive
description of company including history, affiliates and subsidiaries,
products, distribution, competitors, location of other facilities. Outline
background of officers (Complete Supporting Schedule 1).
3. Unionization: Identify unions representing
employees and give history or relationship. Describe any strike within the
preceding five years. Indicate length, terms and expiration of contract.
4. Agreements: Attach copies of options, leases, deeds
and all other appropriate agreements pertaining to project. If agreements have
not been prepared, include a general description of the proposed agreements.
Include copies of the commitment letters from the primary lender. Include a
copy of the Inducement Resolution if financing includes Industrial Revenue
Bonds.
5. Please attach resume(s) or qualification summary of
individual(s) that will manage the project operation.
6. Personal Financial Statements: Please attach
personal financial statements of major stockholders, if a privately held
company, with specific notation of contingent liabilities (guarantees or
endorsements). Statements must be signed and dated by stockholders.
7. Company Financial Statements: Three (3) years
financial statements including all footnotes (audited preferred). All
statements should conform. If fiscal year end is more than six months from
present date, please include interim statements.
If project includes the acquisition of an existing
company, also supply all the above financial information for the company to be
acquired.
8. Projections: Please attach projections for three
(3) years including: balance sheets; profit & loss statements; monthly cash
flow, showing detailed sources of income, disbursements and all debt payments;
amount and sources of additional working capital required for expansion (i.e.
revolving line of credit, trade creditors, etc).
9. Banking Relationship: List present banking
relationships. Include name of financial institution and type of relationship
(i.e. checking, savings, loans). List current loan, savings or checking account
balances. Indicate type of loan (i.e. short term, long term, mortgages,
revolving credit agreement, inventory or accounts receivable financing, etc.),
monthly payments and whether loan is unsecured or collateralized.
Please identify any outstanding tax-exempt financing
issued for the benefit of the applicant, the occupant, or any entity related to
the applicant or occupant, in the same political subdivision where the proposed
project will be located.
Publicly held companies may submit a copy of their
annual report or 10-K in lieu of the above requested information.
10. Additional Information:
A. Real Estate—If the project involves real estate
purchases, construction or renovation please provide the following applicable
information (note: real estate construction/renovation loans will be approved
on a "permanent take out" basis):
(1). Legal description of site and engineering survey
showing metes and bounds and location of building.
(2). Engineering specifications and drawings of building.
(3). Number of acres and square feet of facility at
project site.
(4). Present owner of the site.
(5). Unusual topographical features (if any).
(6). Present zoning classification.
(7). Market appraisal of finished project (selling
price on open market when completed).
(8). Firm bid for construction.
(9). Name of independent engineer who will certify
completed project.
B. Equipment—If project involves the purchase of
equipment, please provide the following information (note: equipment purchases
will be funded upon once project is completed).
(1). Complete list and description of equipment to be
purchased.
(2). Written, firm price quotes with expiration date
of commitment.
(3). Commitment for interim financing, if needed.
(4). Appraisal on real estate to be used as additional
collateral, as per statute.
SUPPORTING SCHEDULE 2—CERTIFICATIONS BY COMPANY
Please answer the following questions by checking the
appropriate space. If the answer to any of the questions is "yes",
please submit additional information on a separate exhibit or attachment.
Referring to company, principal, officer or
stockholders:
|
1.
|
Yes ___
|
No ___
|
Are you presently under indictment, on parole or
probation? (If yes, furnish details in a separate exhibit. List name(s) under
which held, if applicable.)
|
|
2.
|
Yes ___
|
No ___
|
Have you ever been charged with or arrested for any
criminal offense other than a minor motor vehicle violation? (If yes, furnish
details in a separate exhibit. List name(s) under which charged, if
applicable.)
|
|
3.
|
Yes ___
|
No ___
|
Have you ever been convicted of any criminal offense
other than a minor motor vehicle violation?
|
|
4.
|
Yes ___
|
No ___
|
Have you ever been involved in bankruptcy or
insolvency proceedings?
|
|
5.
|
Yes ___
|
No ___
|
Are there any outstanding judgments or is there any
litigation pending against the applicant, project occupant, principal,
officers or principal shareholder? If yes, describe.
|
|
6.
|
Yes ___
|
No ___
|
Has an option agreement or a contract to purchase
the real estate been executed? (If yes, please submit a copy of the executed
agreement or contract).
|
|
7.
|
Yes ___
|
No ___
|
Is there a relationship, legally or by common
control, between the applicant or proposed project occupant and the seller of
property? Identify the seller of the property.
|
|
8.
|
Yes ___
|
No ___
|
Will the proposed project result in the
consolidation of other company operations within the State?
|
Noncommencement Statement:
The undersigned duly authorized officers hereby
certify that the project as outlined in the foregoing application has not
commenced and will not commence prior to the approval of the application by the
West Virginia Economic Development Authority Board.
Compliance With All Applicable Laws &
Regulations:
The undersigned duly authorized officers hereby
certify that the company is in compliance with all applicable federal, state
and local laws and regulations; and does not appear on EPA's List of Violating
Facilities.
Tax Review:
The undersigned duly authorized officers hereby
authorize the State Tax Commissioner to review records relating to the tax
returns of the undersigned to the State of West Virginia or any of its
political subdivisions, together with any particulars found thereon or matters
related thereto, and report to the West Virginia Economic Development Authority
on his findings to the extent necessary to enable the Authority to consider the
financial condition of the undersigned, and in particular, its past and
prospective relationship to West Virginia's taxing.
Corporate Resolution:
The undersigned duly authorized officers hereby
certify that the filing of this application was duly authorized by its Board of
Directors (or governing body), that the statements made in the foregoing
application and in all exhibits and documents submitted in connection therewith
are true and correct to the best information and belief of the undersigned and
are submitted as a basis of the loan.
NAME OF COMPANY
_______________
|
By _________, President
|
Date
_________
|
|
Attest _________,
Secretary
|
|
State of _________,
County of _________, to wit,
The foregoing instrument was acknowledged
before me this _________ day of _________, 19__, by _________, on behalf of
said corporation.
_______________
Notary Public
_______________
Date
Notary Seal
or Stamp
|
Number of FTE Employees
for the West Virginia Project after
|
|
|
|
CATEGORY
|
CURRENT
|
1 YR.
|
2 YR.
|
3 YR.
|
SALARY/WAGE RANGE
|
HEALTH BENEFITS Y or N
|
|
|
|
|
|
|
|
|
Professional
|
|
|
|
|
|
|
|
Clerical & Admin.
|
|
|
|
|
|
|
|
Skilled
|
|
|
|
|
|
|
|
Semi-Skilled
|
|
|
|
|
|
|
|
Unskilled
|
|
|
|
|
|
|
|
Total
|
|
|
|
|
|
|
Our Spam Policy
We hate getting spam as much as you do. So we have implemented a tough spam policy
regading how we deal with your email. We pledge that we will:
- Never rent, trade, or sell any email or any personal information to any third
party without your explicit consent
Terms Of Use
Submissions to this site, including any legal or business forms, posts, responses
to questions or other communications by contributors are not intended as and should
not be construed as legal advice. You are strongly encouraged to consult competent
legal council before engaging in any action based upon content contained on this
site.
These downloadable forms are only for personal use. Retransmission, redistribution,
or any other commercial use is prohibited. This includes reposting forms from this
site to another site offering free legal or other document forms for download.
Please note that the donator may have included different usage terms regarding this
form, and you agree to abide by these terms. It is highly recommended that you have
a licensed attorney review any legal documents for which you are searching in order
to make sure that your needs are being properly and completely satisfied.
Your use of this site constitutes your acceptance of our terms of use and your agreement
to hold this site, its officers, employees and any contributors to this site harmless
for any damage you might incur from your use of any submissions contained on this
site. If you do not agree to the above terms, please do not proceed.
These forms are provided to assist business owners and others in understanding important
points to consider in different transactions. They are offered with the understanding
that no legal advice, accounting, or other professional service is being offered
by these documents or on this website. Laws vary in the different states. Agreements
acceptable in one state may not be enforced the same way under the laws of another
state. Also, agreements should relate specifically to the particular facts of each
situation. Therefore, it is important to consult legal counsel whenever utilizing
these forms. The Forms are not a substitute for legal advice YourFreeLegalForms.com
is not engaged in recommending or referring members on the site or making claims
about the competence, character or qualifications of its participating members.
Close
Thank you for using
Yourfreelegalforms.com
Your online source for 100% free legal and business forms.
Have a form to contribute?
Contribute a legal or business form, checklist or article and have your profile
displayed on the same page as the form for free, powerfull, targeted marketing to
those searching for legal forms and advice.
Rate this form
(must be logged in)
|
|
Social Bookmark this Form
|
|
Keywords: WEST,VIRGINIA,ECONOMIC,DEVELOPMENT,AUTHORITY APPLICATION,FINANCIAL,ASSISTANCE
|
|
|