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17. Industry ofrecipient's facility (Mark one.): <br /> <br /> Manufacturing [3 Services <br /> El Retail Trade El Wholesale Trade <br /> <br />[3 Finance, Insurance, Real Estate <br />El Construction [21 Other (please specify)__ <br /> <br /> 18. Did the recipient relocate as a result of signing this agreement? (Mark one.) <br /> <br /> Yes (Indicate city and state of previous address and reason recipient did not complete this project at that address.) <br /> No (Go to Question 19.) <br /> <br /> City/State of previous address Reason project not completed at previous address <br /> <br /> 19. Would the recipient have remained in previous location or relocated elsewhere if not awarded this business subsidy or <br /> financial assistance? (Mark one.) <br /> [21 Remained at previous location [3 Relocated to different Minnesota location ~/Relocated outside Minnesota <br />Section 3 General Information About the Agreement <br /> 20. Total dollar value of business subsidy or financial 21. Date agreement signed (In addition to the agreement <br /> assistance (Please separate value by type in Questions 24 date, indicate any dates the agreement was amended.) <br /> and25.)~> X~/~ M~/~~ Ze:~>~ <br /> 22. Benefit date (Indicate the date the recipient will benefit from the business subsidy or financial assistance. For example, <br /> indicate the date improvements were finished, equipment was placed into service, or the recipient occupied the property, <br /> whichever is earlier.) ~0 1/t~/*2~ ~5~ 2~t:~// <br /> <br />23. Does the agreement provide a business subsidy or one of the four types of financial assistance (see Question 25) required to <br /> <br />be reported? (Mark one.) <br /> <br />/~business subsidy <br /> <br />24. If the agreement provided a business subsidy, please <br /> indicate the type(s) and total dollar value for each type. <br /> <br />not applicable, agreement provided financial assistance <br /> <br />[3 loan (only principal) $__ <br />0 grant (i.e., forgivable loan) $__ <br />El ta~ abatement $ <br />I~'TIF or other tax reduction or deferral $7t~.,cI::Z5 <br />[3 guarantee of payment $__ <br />El contribution of property or infrastructure $__ <br />[3 preferential use of governmental facilities $__ <br />El land contribution $ <br />[21 other (Specify subsidy type.) $ <br /> <br />26. If the assistance included tax increment financing, please <br /> indicate the type of TIF district? (Mark one.) <br /> <br />not applicable, assistance was not in the form of TIF <br /> <br />I21 redevelopment <br />[3 renewal and renovation <br />~ soils condition <br />j~economic development <br /> [3 mined underground space <br /> El hazardous substance subdistrict <br /> <br />financial assistance <br /> <br />25. If the assistance was one of the four types of financial <br /> assistance, please indicate the type(s). <br /> <br />~/not applicable, agreement provided <br /> a <br /> business <br /> subsidy <br /> <br /> [3 assistance for property polluted $~ <br /> by contaminants <br /> El assistance for renovating building $ __ <br /> stock or bringing it up to code, and <br /> assistance provided for designated <br /> historic preservation districts, when <br /> 50% or less of total cost <br /> 0 assistance for pollution control or $__ <br /> abatement <br /> [21 assistance for a TIF soils condition district $__ <br /> <br />27. Are any other grantors providing a business subsidy or <br /> financial assistance to the same project? (Mark one.) <br /> <br />Yes (Specify each grantor and the value of their <br />assistance below; attach an additional sheet if'necessary.) <br /> <br />Grantor(s) and value of the agreement(s): <br /> <br />Grantor Value ($) <br />Grantor Value ($) <br /> <br />2001 Minnesota Business Assistance Form Page 2 of 4 Department of Trade and Economic Development <br /> <br /> <br />