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ELK RIVER ECONOMIC DEVELOPMENT <br />MICRO LOAN FUND APPLICATION <br />I. CONTACT INFORMATION <br />Legal Name of Business: <br />Address: <br />City /State /Zip <br />Contact Pexson(s~ <br />Business Phone <br />Home Phone <br />Check One: <br />Social Security No. <br />Federal ID # <br />Proprietor Corporation Partnership <br />State ID # <br />II. NATURE OF LOAN REQUEST <br />Which Micro-Loan Program axe you applying fox? <br />Industrial Incentive Pxogxam <br />Redevelopment Financing Pxogxam <br />Amount Requested: $ <br />Total Project Cost: <br />Type of project: <br />New construction fox a start up business. <br />New construction fox an existing business. <br />On site expansion <br />Equipment purchase <br />Remodeling: (circle one) Commercial / Retail ~ Industrial <br />Other <br />Elk River Economic Development Authority Page 9 of 15 <br />;blicxo Loan Fund Application <br />Revised June 2004 <br />