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Economic Development for Austin & Mower County

329 N. Main, Suite 106-L, Austin, MN 55912
Phone: 507-433-9495; Fax: 507-433-9470
Email: austindca@smig.net
Home Page Annual Report Application Austin Information
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Application

  1. BUSINESS CONTACT

    Business Name ________________________________________________________________
    
Contact Person _______________________________________________________________
    
Address ______________________________________________________________________
    
City ________________________ County _____________________ Zip _______________
    
Business Organization:  Corporation __________ Sole Proprietorship ___________
                        Partnership __________ Other _________________________
  2. TYPE OF BUSINESS

    1. Business is:

      New business/start-up __________
      Existing business __________
      If existing, number of years in business __________

    2. Describe the company's business:




  3. EXPANSION/START-UP NEED

    1. Describe your program including need for equity, loan or other form of assistance:




    2. Describe the required financing:

      1. Use of funds:

        1. Fixed Assets:
          Acquisition of land				$ _________________________
Acquisition of building				$ _________________________
Building rehabilitation				$ _________________________
Acquisition of machinery and equipment		$ _________________________

          
Fixed Asset Subtotal				$ _________________________
        2. Working Capital: 
          Inventory					$ _________________________
Operating capital				$ _________________________

          
Working Capital Subtotal			$ _________________________

          TOTAL PROJECT COSTS				$ _________________________
      2. Sources of funds:
             Equity					     $ _________________________
     Bank					     $ _________________________
     DCA (amount of request)			     $ _________________________
     Other	_________________________	     $ _________________________
     		_________________________	     $ _________________________

        
     TOTAL SOURCES				     $ _________________________
    3. Describe sources of equity:




    4. Development start date: _________________________

    5. What collateral do you have available which can be used as security for the proposed financing, and what is its estimated value?




  4. EMPLOYMENT

    1. How many employees does the firm now have?

      full-time  __________     part-time  __________
    2. How many jobs will be created or retained by the proposed project with two years?

      Created		full-time  __________     part-time  __________
Retained	full-time  __________     part-time  __________
    3. What is the salary range of these jobs?

      $ ____________________ / hr   to   $ ____________________ / hr     and/or
$ ____________________ / yr   to   $ ____________________ / yr
  5. ETHNICITY/GENDER

    The information regarding race, color, or national origin designation is requested in order to assure the Federal Government, that The Development Corporation of Austin complies with Federal Laws prohibiting discrimination on the basis of race, color, or national origin. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your request for services or to discriminate against you in any way. However, if you choose not to furnish this information, we are required to note your race and national origin on the basis of visual observation or surname.

    Please check the appropriate information below:

    Racial Categories

    		 Ethnic Categories
    _____ American Indian or Alaskan Native _____ Hispanic or Latino
    _____ Asian _____ Not Hispanic or Latino
    _____ Black or African American  
    _____ Native Hawaiian or Pacific Islander  
    _____ White  

  6. PARTICIPATING LENDER

    I have reviewed the preceding proposal. Based on this preliminary review and discussion, our bank will consider participating in the financing of this project assuming the following:

    Furthermore, I understand that this indication of interest to participate with DCA in financing the project described herein does not obligate this bank to actually approve such financing unless and until the above mentioned conditions, and any others which this bank may reasonably request, have been met to the full satisfaction of this bank, and a letter to that affect, signed by an officer of this bank, has been delivered to the DCA Board of Directors.

         NAME OF BANK _____________________________________________________________

    
     NAME OF OFFICER __________________________________________________________

    
     TELEPHONE/FAX NUMBER______________________________________________________

    
     SIGNATURE_______________________________TITLE ____________________________
  7. ENCLOSURES

    1. Complete business plan (include current & projected financial statements)
    2. Most recent tax return (start up and early stage companies)
    3. Personal Financial Statement (start up and early stage companies)


    Development Corporation is an Equal Opportunity Lender and Employer